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Tobacco Use and Dependence

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Chronic Illness Care

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Abstract

Tobacco use and dependence remains the number one preventable cause of disease and death. While smoking rates have dropped significantly over the past 50 years, they remain high in certain populations, including those with serious mental health conditions and in low-income and low-education populations. Patients may utilize multiple forms of tobacco, including cigarettes, cigars, smokeless tobacco, and electronic nicotine delivery systems (also called e-cigarettes or vapes). Tobacco use causes or contributes to many chronic diseases, and tobacco dependence is considered a chronic disease itself. Tobacco cessation counseling, even if brief, significantly improves cessation outcomes. Successful cessation often requires repeated intervention and multiple attempts to quit. The Chronic Care Model can improve health outcomes through system changes and a population health approach to support patient-centered and evidence-based care, including team-based care, planned interventions, self-management tools, telehealth, connection to community resources, integrated decision support, patient registries, information technology supports, and quality improvement initiatives. A comprehensive tobacco control program includes policy enactment and enforcement, including effective clean air policies, higher taxes on tobacco products, media campaigns, marketing and tobacco access restrictions, and access to treatment services.

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Authors and Affiliations

  1. Department of Family Medicine, Program on Health and Clinical Informatics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Kimberly A. Shoenbill

  2. Lineberger Comprehensive Cancer Center, University of North Carolina Health Care System, Chapel Hill, NC, USA

    Kimberly A. Shoenbill, Ashley A. Weiner & Adam O. Goldstein

  3. Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    M. Justin Byron & Adam O. Goldstein

  4. Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Ashley A. Weiner

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  1. Department of Family Medicine, University of North Carolina, CHAPEL HILL, NC, USA

    Timothy P. Daaleman

  2. Department of Family Medicine, University of North Carolina, CHAPEL HILL, NC, USA

    Margaret R. Helton

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Shoenbill, K.A., Byron, M.J., Weiner, A.A., Goldstein, A.O. (2023). Tobacco Use and Dependence. In: Daaleman, T.P., Helton, M.R. (eds) Chronic Illness Care. Springer, Cham. https://doi.org/10.1007/978-3-031-29171-5_4

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