New Recommendations in the PHS-Sponsored Clinical Practice Guideline—Treating Tobacco Use and Dependence: 2008 Update
Most, but not all, of the new recommendations appearing in the 2008 Update of the Guideline resulted from new meta-analyses of the topics chosen by the Guideline panel.
1. Formats of Psychosocial Treatments
Recommendation: Tailored materials, both print and Web-based, appear to be effective in helping people quit. Therefore, clinicians may choose to provide tailored, self-help materials to their patients who want to quit.
2. Combining Counseling and Medication
Recommendation: The combination of counseling and medication is more effective for smoking cessation than either medication or counseling alone. Therefore, whenever feasible and appropriate, both counseling and medication should be provided to patients trying to quit smoking.
Recommendation: There is a strong relation between the number of sessions of counseling when it is combined with medication and the likelihood of successful smoking abstinence. Therefore, to the extent possible, clinicians should provide multiple counseling sessions, in addition to medication, to their patients who are trying to quit smoking.
3. For Tobacco Users Not Willing To Quit Now
Recommendation: Motivational intervention techniques appear to be effective in increasing a patient's likelihood of making a future quit attempt. Therefore, clinicians should use motivational techniques to encourage smokers who are not currently willing to quit to consider making a quit attempt in the future.
4. Nicotine Lozenge
Recommendation: The nicotine lozenge is an effective smoking cessation treatment that patients should be encouraged to use.
Note: Go to the Guideline and FDA Web site (http://www.fda.gov) for additional information on the safe and effective use of medication.
Recommendation: Varenicline is an effective smoking cessation treatment that patients should be encouraged to use.
Note: Go to the Guideline and the FDA Web site (http://www.fda.gov) for additional information on the safe and effective use of medication.
6. Specific Populations
Recommendation: The interventions found to be effective in this Guideline have been shown to be effective in a variety of populations. In addition, many of the studies supporting these interventions comprised diverse samples of
tobacco users. Therefore, interventions identified as effective in this Guideline are recommended for all individuals who use tobacco except when medically contraindicated or with specific populations in which medication has not been shown to be effective (pregnant women, smokeless tobacco users, light (<10 cigarettes/day) smokers, and adolescents).
7. Light Smokers
Recommendation: Light smokers should be identified, strongly urged to quit and provided counseling treatment interventions.
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Tobacco dependence is a chronic disease that deserves treatment. Effective treatments have now been identified and should be used with every current and former smoker. This Quick Reference Guide for Clinicians provides clinicians with the tools necessary to effectively identify and assess tobacco use, and to treat:
- Tobacco users willing to quit.
- Those who are unwilling to quit at this time.
- Former tobacco users.
There is no clinical treatment available today that can reduce illness, prevent death, and increase quality of life more than effective tobacco treatment interventions.
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This Guideline is available in several formats suitable for health care practitioners, the scientific community, educators, and consumers.
The Clinical Practice Guideline—Treating Tobacco Use and Dependence: 2008 Update—presents recommendations for health care providers with supporting information, tables and figures.
The Quick Reference Guide for Clinicians is a distilled version of the clinical practice guideline, with summary points for ready reference daily.
Helping Smokers Quit: A Guide for Clinicians is a pocket guide that presents a brief
summary of the 5 A’s, including a chart regarding medications.
Help for Smokers and Other Tobacco Users is an informational booklet designed for tobacco users with limited formal education.
The full text of the guideline documents, references, and the meta-analyses references for online retrieval are available by visiting the Surgeon General's Web site (http://www.surgeongeneral.gov/tobacco/default.htm).
Single copies of these guideline products and further information on the availability of other derivative products can be obtained by calling any of the following Public Health Service clearinghouses toll-free numbers:
Agency for Healthcare Research and Quality (AHRQ)
Centers for Disease Control and Prevention (CDC)
National Cancer Institute (NCI)
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Current as of May 2009
Treating Tobacco Use and Dependence. Quick Reference Guide for Clinicians. April 2009. U.S. Public Health Service. Agency for Healthcare Research and Quality. http://www.ahrq.gov/clinic/tobacco/tobaqrg.htm