Cent Eur J Public Health 2017, 25(2):141-144

Treatment of Tobacco Dependence, a Critical Gap in Czech Clinical Practice Guidelines

Kamila Zvolská1, Keely Fraser1,2, Miroslav Zvolský3, Eva Králíková1,2
1 Centre for Tobacco-Dependent of the 3rd Medical Department, Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
2 Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
3 Institute of Health Information and Statistics, Prague, Czech Republic

Objective: Tobacco related comorbidities and treatment of dependence are relevant to clinicians of all disciplines. Clinicians should provide a brief intervention about tobacco use with smokers at each clinical contact (success rate of 5-10 %). Intensive treatment (success rate >30%) should be available to those who need it. Brief intervention is not yet standard clinical practice. Our aim was to assess clinical practice guidelines (CPG) of selected medical professional societies to determine whether or not tobacco dependence treatment recommendations were included.

Methods: Between October and December 2013, we conducted a keyword search of CPG for 20 medical professional societies in the Czech Republic. We searched for the keywords "smoking", "tobacco" and "nicotine addiction" in 91 CPG documents, which were freely available on the websites of selected professional societies. We focused specifically on CPG relating to cardiovascular and respiratory diseases as well as cancer. We excluded any CPG focused on acute conditions, diagnostics only, laboratory methods, or administration.

Results: There was no mention of smoking in 27.7% (26/94) of CPG documents. Only 16% (15/94) of CPG documents listed smoking as a risk factor. 42.5% (40/94) mentioned smoking related phrases (e.g. "smoking ban"). Only 13.8% (13/94) of CPG included a section on tobacco dependence, referenced tobacco dependence treatment guidelines or mentioned specialized treatment centres where smokers can be referred.

Conclusion: Nearly one third of CPG related to cardiovascular and respiratory diseases as well as cancer made no mention of smoking. Despite the clinical significance of smoking, the majority of CPG did not adequately address tobacco dependence and its treatment.

Keywords: tobacco dependence, brief intervention, treatment, clinical practice guidelines, Czech Republic

Received: November 30, 2015; Revised: May 21, 2017; Accepted: May 21, 2017; Published: June 1, 2017  Show citation

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Zvolská K, Fraser K, Zvolský M, Králíková E. Treatment of Tobacco Dependence, a Critical Gap in Czech Clinical Practice Guidelines. Cent Eur J Public Health. 2017;25(2):141-144. PubMed PMID: 28662325.
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