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Stoptober is an annual campaign aimed at helping people with their efforts to give up smoking. Support is available in many forms: smokers who are trying to quit can download the Stoptober app, sign up for daily motivational emails, join an online chat group, get a personalised quit plan, or read stories from ex-smokers and others who are trying to kick the habit. But why is it so important to support people on their journey from smoker to ex-smoker?

The negative impacts of smoking are well documented and affect multiple organ systems. Smoking is a risk factor for chronic obstructive pulmonary disease (COPD) and a leading cause of lung cancer. Brief interventions at opportunistic moments can give people who smoke the incentive to forego a lifelong habit. A diagnosis of either COPD or lung cancer can provide a valuable teachable moment to motivate people to give up smoking and take steps towards improving their health.

In July 2019, NICE updated its guideline on the diagnosis and management of COPD to reflect new evidence around inhaled triple therapy for stable COPD and systemic corticosteroids for managing exacerbations. One of the most important interventions for people with COPD is to offer treatment and support to stop smoking—this should be covered at every clinical contact, along with four other fundamentals of COPD care.

Dr Karen Sennett draws out the key learning points for primary care following the update. The article includes a new visual summary of non‑pharmacological management and use of inhaled therapies for people with COPD, and was developed by NICE to be used alongside the guideline. 

Lung cancer is the most common cause of cancer death in the UK. Around 80% of cases of lung cancer are preventable and most are caused by smoking. Primary care plays an essential role in helping patients to reduce their risk of lung cancer by giving up smoking. Advice about smoking cessation is important for people who already have a diagnosis, because quitting around the time of diagnosis leads to significantly better survival. 

Dr Anthony Cunliffe and Dr Richard Simcock provide 10 top tips on lung cancer for primary care, covering:

  • patients who are at increased risk 
  • typical and atypical symptoms 
  • conventional and new treatments that are available and their side-effects
  • how to support patients with treatment decisions
  • the importance of helping patients to reduce their risk by stopping smoking
  • when to involve palliative services.

An image depicting a light micrograph of small-cell lung cancer

Top tips: lung cancer

Dr Anthony Cunliffe and Dr Richard Simcock

Also covered in this issue of Guidelines in Practice:

Dr Janice Allister summarises the relevant recommendations for primary care from the updated NICE guideline on depression in children and young people. This article is accompanied by a new offering to support you with your CPD; test and reflect patient scenarios include a number of hypothetical case studies, giving you the opportunity to think about how you would manage specific cases based on what you have learnt from the article. They include questions to prompt reflection and can be used for individual learning or for group discussion in a practice or education meeting.

Samantha Cudby and Gupinder Syan explain the role of the practice pharmacist in managing polypharmacy in frail older patients, and provide practical steps towards setting up a pharmacist‑led frailty clinic. The article highlights that: ‘Polypharmacy itself should be thought of as a “disease” with potentially more serious complications than those of the diseases that the medications have been prescribed to treat’.

In the View from the ground article, Dr Zoe Norris reflects on the importance of showing appreciation for colleagues, particularly given the current pressures faced by the general practice workforce.

Cancer, COPD, and depression in children and young people will be covered in sessions delivered by experts at our Guidelines Live event next month. Excitement is building here at MGP as the final preparations get underway. It is not too late to book your place to attend on one or both days, and there are a number of educational bursaries still available for healthcare professionals. Guidelines Live will take place at Olympia London on 19–20 November—for more details visit: www.guidelines.co.uk/live19