Tobacco in my speciality - a pocket guide for specialists

Background and challenges to implementation: In spite of the enormous disease burden caused by tobacco use most doctors fail to inspire or help their smoking/snus using patients to stop. Even when agreed that stopping smoking is the only way to ease symptoms, stop disease progression or decrease mortality, smoking cessation is not the first choice in the clinical toolbox. The reasons for this ineptitude may range from lack of knowledge about disease causality to lack of training or tools of helping patients to stop using tobacco. Intervention or response: We developed a pocket guide with condensed updated knowledge of what is known about tobacco use (mainly smoking) in 6 different specialities. Our first guides were written for general practice, orthopaedics, ophthalmology, rheumatology, dermatology and gastro-intestinal diseases. The text varies between disciplines according to the strength of the available evidence. The guides zoom in on the role of tobacco and are sectioned as follows: a short introduction, causality, current awareness of tobacco-related causality, evidence of causality, current treatment strategies, effects of cessation, references. Less than half of the available space is text (7-800 words) and the rest shows the distinctive front, illustrations, logotypes etc. The complete content can be downloaded and printed double sided on a standard A4 sheet. Results and lessons learnt: The Swedish Medical Association sponsored and distributed the first batch of pocket guides and The Swedish Society of Medicine and the NGO Doctors Against Tobacco have since supported the project. National specialist organisations have endorsed the project. A pilot study will be reported. Conclusions and key recommendations: A very compact and easy to read pocket folder may serve as a reminder for clinicians of the role of tobacco in their speciality and initiate cessation.