Laura Jean Bierut, MD of Washington University of Medicine discusses the three levels of smoking cessation. These levels are (1) Patient, (2) Systems and (3) Public Health. Health care providers and those who promote smoking cessation should be working in those three levels. In the provider level, counselling and medications should be provided, and this is a known fact. However, at the systems level it is very important that smoking cessation should be embedded with all the health care providers including medical assistance, nursing staff and physician.
Dr. Bierut found that there is unease in doing smoke cessation when patients are very sick. However, most patients are willing to get smoking cessation treatment despite their situation and to accept it from the health care providers. So, as health care providers, it is very important to eliminate that discomfort at all levels and push the system to make sure that its embedded at all levels.