Smoking Cessation For the Busy Clinician

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The Bottom Line

>> Cigarette smoking is the leading preventable cause of premature death in the US. Because many patients desire to quit smoking, clinicians can play an important role in the process.

>> Effective medications are available, including nicotine replacement therapy (NRT) products (gum, lozenge, patch, nasal spray, and oral inhaler), combination NRT (eg, patch plus gum, lozenge, nasal spray or oral inhaler), sustained-release (SR) bupropion, and varenicline. Unless medically contraindicated, all patients who are trying to quit should be encouraged to use 1 or more FDA-approved medications.

>> Medication therapy should be combined with behavioral counseling to further increase patients’ chances for success.

What You Can Do

>> For the busy clinician, Ask-Advise-Refer: ask all patients about tobacco use, advise tobacco users to quit, and refer tobacco users who are ready to quit (eg, in the next month) to other resources and programs.

>> In states where authorized, become engaged in prescribing smoking cessation medications. In other states, become active in promoting legislation for prescribing of smoking cessation medications.>

>> Consider smoking cessation counseling as part of routine services, similar to immunizations and diabetes care.

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