Steps of the L-MIS protocol [1]
- Step 1:
Quick smoking cessation advice by the lung physician.
- Step 2:
Smoking characteristics. Ask about the patients’ smoking status, cigarettes smoked per day, and readiness to quit. Nicotine addiction is defined by smoking more than 15 cigarettes per day or smoking the first cigarette within 30 min after waking up in the morning.
- Step 3:
Motivation for quitting. Ask readiness for quitting and reasons for smoking and quitting. Discuss health risks of smoking and the pros of quitting.
- Step 4:
Barriers of quitting. Discuss barriers of quitting and problems with previous quit attempts. Increase self-efficacy.
- Step 5:
Target quit date (TQD). Make arrangements for quitting and planning of a target quit date.
- Step 6:
Discuss the use pharmacological aids. The protocol recommends to use NRT particularly in nicotine addicted smokers and bupropion in addicted smokers who had several previous quit attempts.
- Step 7:
Follow-up. Evaluation of the quit attempt. Motivate quitters to refrain from smoking and relapsers to start a new quit attempt.
Steps 2–6 occur during the first and second consultation (2 weeks later) with the respiratory nurse. The duration of both consultations is 30–45 min. A telephonic consultation is planned on the TQD. Follow-up consultations are recommended 2 weeks after the TQD and after 3, 6, and 12 months (5–10 min each).