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PCRS believe that it is the responsibility of every healthcare professional to treat tobacco dependency systematically and effectively. PCRS advocate that people wishing to quit using tobacco should be offered the most effective but also the least harmful methods first to support a quit attempt. People wishing to use nicotine e-cigarettes to quit should be encouraged to use the support offered by NHS stop smoking services including the ‘swap to stop’ scheme in England. A tobacco quit attempt should be followed ultimately by stopping e-cigarette use as well due to safety concerns.

Tobacco dependency is a long-term relapsing condition that usually starts in childhood This tobacco dependency pragmatic guide is a practical, immediately implementable, evidence-based framework to enable healthcare professionals to routinely identify smokers, encourage a quit attempt and support that quit attempt within the real-world context of their own professional sphere.

Dr Roy Robertson is a Professor of Addiction Medicine at the Usher Institute of Population Health Sciences and Informatics at the University of Edinburgh. He has spent much of his career on the frontline of Edinburgh’s heroin problem working as a GP on the Muirhouse estate.

In the third in our series of snapshot case vignettes aimed at illustrating self-management opportunities Dr Iain Small brings you the case of Gerald. Three healthcare professionals have provided their feedback on the case. How would you respond?

Are you interested in or concerned about respiratory care and services in your area? Would you like to improve the quality of care for patients with respiratory disease and feel you need some help to make that case to your practice manager or local commissioner? All it needs is just one person to take the initiative. That's how change starts and that's who you will meet on this course. Find out more about our Respiratory Leadership Programme.

Developed by the PCRS Service Development Committee, the Respiratory Service Framework (RSF) helps those looking to design a patient focussed respiratory service working across all sectors of out of hospital care to see the ideal components for a given population of patients. It has been designed to be applicable and helpful to those delivery care at a PCN or ICS level.

In this article from Primary Care Respiratory Update, Spring 2018, Fran Robinson, discusses the use of rescue packs with Dr John Hurst, Honorary Consultant at the Royal Free London NHS Foundation Trust and Reader in Respiratory Medicine at University College (UCL) London.

In this article from the Spring 2018 issue of Primary Care Respiratory Update, Dr Noel Baxter discusses how to influence change.

In this feature from the Spring 2018 issue of Primary Care Respiratory Update, Dr Stephen Holmes discusses a case history of a presentation of mesothelioma.