Smoking Cessation Evidence and Resources

About 42 million people in the United States (nearly 18 percent of the population) currently smoke. Tobacco use is a leading cause of illness, disability, and death in the United States. Cigarette smoking accounts for one out of every five deaths and is estimated to increase the risk for heart disease and stroke by two to four times. Smoking during pregnancy increases the risk of congenital anomalies, perinatal complications, miscarriage, and stillbirth. Substantial clinical evidence shows that quitting smoking is one of the most important things a person can do for his or her health.

What PCOR Evidence Did EvidenceNOW Use?

Here are the PCOR findings used by EvidenceNOW for smoking cessation:

In 2015, the U.S. Preventive Services Task Force released evidence-based recommendations for behavioral and pharmacological interventions to help people quit smoking. The recommendations are based on a systematic review of literature on the effectiveness of these interventions.

Recommendation: The USPSTF recommended that clinicians ask all adults about tobacco use, advise them to stop using tobacco, and provide behavioral interventions. For non-pregnant adults, the USPSTF recommends clinicians provide U.S. Food and Drug Administration (FDA)-approved pharmacotherapy for cessation.

How Did EvidenceNOW Evaluate Whether Practices Followed This PCOR Evidence?

The measure used by EvidenceNOW to evaluate smoking cessation support reflects the percentage of patients ages 18 and older who were screened for tobacco use and received a cessation counseling intervention if they were identified as a tobacco user.

This measure has been endorsed by the National Quality Forum (NQF 0028) and is used by the Centers for Medicare & Medicaid Services. (Measure ID: CMS138)

The EvidenceNOW goal for primary care practices in the study is to have at least 70 percent of eligible patients be screened for tobacco use and have those identified as tobacco users receive smoking cessation counseling.

Smoking Cessation Resources

Recommendations and Guidelines

Behavioral and Pharmacotherapy Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Women: U.S. Preventive Services Task Force Recommendation Statement
This clinical guideline describes recommended interventions to prevent tobacco use and related disease. This guideline is considered a key PCOR finding for dissemination to clinicians participating in EvidenceNOW.

Behavioral Counseling and Pharmacotherapy Interventions for Tobacco Cessation in Adults: A Review of Reviews for the U.S. Preventive Services Task Force
This comprehensive report synthesizes evidence on the use of behavioral counseling and medication treatments to help adults quit smoking.

Treating Tobacco Use and Dependence: 2008 Update
This update to a previous guideline by the Tobacco Use and Dependence Guideline Panel contains strategies and recommendations for effective treatments for tobacco use and dependence.

Resources for Practices

EvidenceNOW PCOR Smoking Cessation Fact Sheet
This EvidenceNOW fact sheet provides an overview of PCOR findings about the risks of smoking, health benefits of quitting smoking, and the effectiveness of behavioral counseling and medications to assist patients in smoking cessation.

Smoking Cessation in Primary Care
This facts-at-a-glance handout for clinicians summarizes evidence, risks, benefits, and recommendations for counseling patients and choosing a treatment plan for smoking cessation.

Smoking Cessation: Tasks for the Practice Facilitator
This two-page checklist and associated materials outline working with primary care practices to increase the rate of smoking cessation counseling for patients who smoke.

New Resources To Help Providers Help Smokers Quit
This presentation reviews additional resources, including a protocol and treatment action guide, that health care professionals can use to help patients quit smoking.

Ready or Not…Addressing Tobacco Use
This script and slide deck from a 14-minute presentation cover the risks of smoking and the benefits of quitting, and reviews 5 A’s for treating tobacco use (Ask, Advise, Assess, Assist, and Arrange), as well as common misconceptions.

Integrating Tobacco Cessation Into Electronic Health Records
These recommendations outline inclusion of a template in electronic health record systems that prompts clinicians to counsel about smoking prevention and cessation when patients present for well-patient exams or with symptoms or conditions associated with smoking.

Resources for Practices To Use With Patients

Tobacco Use Self-Management Tool
This fact sheet for patients reviews reasons to manage and/or quit tobacco use as well as steps, tips, and resources for increasing chances of success.

Dispelling Myths About Nicotine Replacement Therapy
This fact sheet for patients reviews and refutes common myths about nicotine replacement therapy to assist in smoking cessation.

Page last reviewed September 2018
Page originally created August 2018
Internet Citation: Smoking Cessation Evidence and Resources. Content last reviewed September 2018. Agency for Healthcare Research and Quality, Rockville, MD.
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