คู่มือการบำบัดโรคเสพติดผลิตภัณฑ์ยาสูบสำหรับผู้ให้บริการในโรงพยาบาล

Objectives

The material is a practical tobacco-dependence treatment resource for hospital and health-service providers. Its identifiable focus is to support tobacco-use screening, brief intervention, counselling, treatment, referral and information recording, rather than to set out a broader public-health mission or strategic framework.[1][2]The available extracts do not provide a coherent overarching mission, comprehensive strategic goals, implementation targets, or a reliable wider policy framework; some sections are substantially affected by OCR or legacy-font extraction artefacts.[3][4][5][6]

• Identify tobacco use and tobacco dependence through assessment and categorisation, including assessment related to the number of cigarettes smoked.[2][7]
• Deliver cessation support through brief advice, brief intervention or counselling, intensive counselling, motivational interviewing, and counselling combined with medication.[8][9]
• Apply the five-part cessation sequence of Ask, Advise, Assess, Assist and Arrange follow-up.[2]
• Promote motivational counselling using the 5R framework: Relevance, Risks, Rewards, Roadblocks and Repetition.[2]
• Support management of cravings and cessation attempts through the 5D techniques: Delay, Deep Breath, Drink Water, Do something else, and Destination or changing the immediate environment.[2]
• Record service contacts and cessation outcomes through coding and follow-up arrangements.[1][10][7]
• Increase awareness of cigarette-related harms and provide supporting questions and answers for brief counselling, where relevant to provider-delivered tobacco-control activity.[1]

Implementation

The delivery model combines provider-led identification and counselling with follow-up, clinical coding, referral and information recording.[1][8]Brief advice is described as lasting about one to three minutes, while the intervention pathway incorporates asking about tobacco use, advising cessation, assessing readiness or dependence, assisting the person, and arranging follow-up.[8][2]The extracts do not clearly specify responsible institutions, governance structures, workforce requirements, stakeholder roles, or detailed referral responsibilities.[1][2][11]

• Provide a tiered intervention offer comprising brief advice, brief intervention or counselling, intensive counselling, motivational interviewing, and counselling with medication.[8][9]
• Use motivational counselling for people who are not ready to stop, structured around personal relevance, risks, potential rewards, barriers and repeated engagement.[2]
• Support cessation attempts with practical craving-management techniques, including delaying tobacco use, breathing deeply, drinking water, undertaking another activity, and changing the immediate environment.[2]
• Use pharmacological cessation options including varenicline, nortriptyline and sustained-release bupropion, with dosing schedules and treatment durations described in the readable clinical material.[12]
• Monitor closely, or avoid particular medicines where indicated, for pregnant women and for people with specified renal, neurological, psychiatric, cardiac, or monoamine oxidase inhibitor-related considerations.[12]
• Classify tobacco use as International Classification of Diseases, 10th Revision code F17.1 and tobacco dependence as F17.2; use Z71.6 for tobacco-abuse counselling or brief intervention.[2][11]
• Record assessment, counselling-related services and follow-up encounters through operational service codes.[10][7][13]
• Arrange follow-up at one, three and six months after cessation support.[9][7][13]At one and three months, record whether the person continues smoking at the same level, has reduced smoking, or has stopped smoking.[9]At three and six months, record continued smoking, reduced cigarette consumption, or no longer smoking.[10]
• Maintain information recording as an operational component of hospital-provider guidance, although the extracts do not specify formal reporting systems, performance targets, surveillance methods, evaluation designs, or accountability arrangements.[1][10][7]

Monitoring & Evaluation

Monitoring centres on recording tobacco-use assessment, cessation support, follow-up, and outcomes within hospital and health-promotion services.[1][9][10]

• Record information as an operational component of guidance for hospital providers delivering tobacco-dependence treatment.[1]
• Assess tobacco use through the five-part sequence of Ask, Advise, Assess, Assist, and Arrange follow-up; the material also includes assessment scoring or categorisation tables.[2][11]
• Classify tobacco use as International Classification of Diseases, 10th Revision code F17.1, tobacco dependence as F17.2, and tobacco-abuse counselling or brief intervention as Z71.6.[2][11]
• Record follow-up at one, three, and six months after cessation support, including for people receiving brief advice, counselling, or counselling combined with medication.[9][7][13]
• Track outcomes at follow-up by distinguishing continued smoking at the same level, reduced smoking, and no longer smoking.[9]At three and six months, the same outcome categories are recorded in the service-coding material.[10]
• Monitor selected patients closely when using Varenicline, particularly people with specified renal, neurological, psychiatric, cardiac, pregnancy-related, or medicine-interaction considerations.[12]

The available material provides service, assessment, follow-up, and outcome records, but does not specify quantified performance indicators, targets, routine reporting arrangements, surveillance systems, formal evaluation methods, or named accountability bodies.[1][2][14][10][7]

Some source fragments are substantially affected by OCR and legacy-font extraction artefacts, limiting reliable interpretation of any additional monitoring or accountability provisions.[5][6][15]

Costing & Financing

No explicit costing or financing framework is provided in the available material. Costs, budgets, unit prices, funding sources, allocations, funding gaps, resource-mobilisation measures, and economic assumptions are not specified.[16][1][8][2][11][3][12][4][14][17][9]

• Provide tobacco-cessation support through brief advice, counselling, counselling combined with medication, and follow-up, but without associated budget or financing information.[9][7][13]
• Present pharmacological cessation options, including Varenicline, Nortriptyline, and Bupropion-SR, with treatment schedules and durations, but without medicine prices, reimbursement arrangements, procurement costs, or affordability assumptions.[12]
• Describe hospital-provider recording, assessment, referral-related components, and coding arrangements without identifying resources for staff, information systems, referral services, or implementation.[1][2][11]
• Provide no reliable additional financing detail in source fragments affected by substantial OCR and legacy-font extraction artefacts.[5][6][15]

Accordingly, the material does not permit estimation of programme costs, financing needs, funding gaps, or the relative cost of counselling, follow-up, or medication-based cessation support.[16][3][14]