Tobacco cessation fall 2011 Instructor (1)_ For use in lecture (3)

Tobacco cessation counseling provided at no cost via

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Unformatted text preview: Tobacco cessation counseling, provided at no cost via telephone to all Americans Staffed by trained spets Up to 4 – 6 personalized sessions (varies by state) Some state quitlines offer nicotine replacement therapy at no cost (or reduced cost) Up to 30% success rate for patients who complete sessions Most health-care providers, and most patients, are not familiar with tobacco quitlines. Courtesy of Mell Lazarus and Creators Syndicate. Copyright 2000, Mell Lazarus. AIDS for CESSATION & CASE SCENARIO OVERVIEW METHODS for QUITTING Nonpharmacologic Counseling and other non-drug approaches Pharmacologic FDA-approved medications Counseling and medications are both effective, but the combination of counseling and medication is more effective than either alone. Fiore et al. (2008). Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: USDHHS, PHS, May 2008. NONPHARMACOLOGIC METHODS Cold turkey: Just do it! Unassisted tapering (fading) Reduced frequency of use Lower nicotine cigarettes Special filters or holders Assisted tapering QuitKey Computer developed taper based on patient’s smoking level Includes telephone counseling support NONPHARMACOLOGIC METHODS (cont’d) Formal cessation programs Self-help programs Individual counseling Group programs Telephone counseling 1-800-QUITNOW 1-800-786-8669 Web-based counseling www.smokefree.gov www.quitnet.com www.becomeanex.org Acupuncture therapy Hypnotherapy Massage therapy PHARMACOTHERAPY Fiore et al. (2008). Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: USDHHS, PHS, May 2008. Medications significantly improve success rates. * Includes pregnant women, smokeless tobacco users, light smokers, and adolescents. “Clinicians should encourage all patients attempting to quit to use effective medications for tobacco dependence treatment, except where contraindicated or for specific populations* for which there is insufficient evidence of effectiveness.” PHARMACOLOGIC METHODS: FIRST-LINE THERAPIES Three general classes of FDA-approved drugs for smoking cessation: Nicotine replacement therapy (NRT) Nicotine gum, patch, lozenge, nasal spray, inhaler Psychotropics Sustained-release bupropion Partial nicotinic receptor agonist Varenicline PHARMACOTHERAPY: USE in PREGNANCY The Clinical Practice Guideline makes no recommendation regarding use of medications in pregnant smokers Insufficient evidence of effectiveness Category C: varenicline, bupropion SR Category D: prescription formulations of NRT “Because of the serious risks of smoking to the pregnant smoker and the fetus, whenever...
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Tobacco cessation fall 2011 Instructor (1)_ For use in lecture (3)

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