198. Specific Populations and Other Topics (Continued)

Treating Tobacco Use and Dependence: 2008 Update
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Evidence of effectiveness of tobacco dependence interventions in specific populations

Population of Smokers Review of Evidence
Psychiatric disorders including substance use disorders (Continued)
  • Currently, there is insufficient evidence to determine whether smokers with psychiatric disorders benefit more from tobacco use treatments tailored to psychiatric disorder/symptoms than from standard treatments.
  • Evidence indicates that tobacco use interventions, both counseling and medication, are effective in treating smokers who are receiving treatment for chemical dependency.
  • There is little evidence that tobacco dependence interventions interfere with recovery from nontobacco chemical dependencies among patients who are in treatment for such dependencies. One study suggests that delivery of smoking cessation interventions concurrent with alcohol dependence interventions may compromise alcohol abstinence outcomes, although there was no difference in smoking abstinence rates.
  • The use of varenicline has been associated with depressed mood, agitation, suicidal ideation, and suicide. The FDA recommends that patients should tell their health care provider about any history of psychiatric illness prior to starting varenicline and clinicians monitor for changes in mood and behavior when prescribing this medication. In light of these FDA recommendations, clinicians should consider eliciting information on their patients' psychiatric history. For more information, see the FDA package insert.

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Page last reviewed October 2014
Internet Citation: 198. Specific Populations and Other Topics (Continued). October 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/tobacco/clinicians/presentations/2008update-full/slide198.html