Where there's smoke … there's council tax valuation band A

[摘要] Cigarette smoking, more than any other known factor, reduces healthy life expectancy;1 so smoking cessation is a supremely important health-promotion target. How this is best achieved is the thrust of a massive report by West2 and colleagues in 2000. Although it included not a single ‘journeyman’ GP, this panel of ‘experts’ saw primary care clinicians as best placed to intervene effectively and recommended that, during routine consultations, GPs should be advising smokers to stop. But even before the report appeared, the practicality of this edict was being questioned: smoking habit is discussed in only 20–30% of everyday GP consultations with smokers.3 Merely urging GPs to advise smoking cessation seems unlikely to succeed; the gulf between ‘symptom-led’ activity and ‘population-based’ interventions is too wide. How, then, should we close the gap between ambition and reality? The obvious answer would seem to be for GPs being primed — to know, in advance, which patients are most likely to be smokers and for this additional burden in consultations to be embarked on only where relevant. After all, consultations in UK general practice are events that are already uncomfortably overcrowded.

[学科分类] 卫生学