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Treating Tobacco Use in Clinical Practice

  • Allison J. Carroll
  • Anna K. Veluz-Wilkins
  • Brian HitsmanEmail author
Chapter

Abstract

Tobacco use is the leading cause of preventable death, yet cigarette-smoking rates in the USA have stagnated just below 20 %. With the signing of the Affordable Care Act came increased coverage for evidence-based tobacco cessation treatment, providing a wide range of effective cessation options that can now be offered to all tobacco-using patients, especially cigarette smokers. Health-care providers should be familiar with pharmacotherapy recommendations and counseling strategies for smoking patients at all stages of quitting. We discuss practical cessation approaches for patients ready to quit, unwilling to quit right away, and those who have recently quit. Certain groups, especially tobacco users with comorbid medical and/or psychiatric conditions, remain high tobacco burden populations that have not demonstrated declining rates of tobacco use as have been observed in the general population. Despite their higher tobacco burden status, treatments are effective for these populations and are especially important to include in their routine medical care. We end with a discussion of the emerging issues relevant for cessation treatment, including the increasing use of other tobacco and smoking products (such as e-cigarettes, hookah, and chewing tobacco) and their impact on smoking cessation efforts and the Affordable Care Act, keeping in mind that the exact parameters have not yet been set.

Keywords

Cigarette smoking Smoking cessation Clinical treatment e-Cigarettes Smoking disparities 

Abbreviations

AA

African-American

AAFP

American Academy of Family Physicians

ACA

Affordable Care Act

CI

Confidence interval

COPD

Chronic obstructive pulmonary disease

EHR

Electronic Health Record

ENDS

Electronic nicotine delivery systems

FAQ

Frequently Asked Questions

FDA

Food and Drug Administration

GED

General Educational Development

H

Hispanic

LGBTQ

Lesbian, gay, bisexual, transgender, and questioning

MAO

Monoamine oxidase

NRT

Nicotine replacement therapy

OB/GYN

Obstetrician/gynecological

OTC

Over-the-counter

PHS

Public Health Service

RCT

Randomized clinical trial

Rx

Prescription product

SES

Socioeconomic status

SIDS

Sudden infant death syndrome

SR

Sustained release

USPSTF

US Preventive Services Task Force

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Allison J. Carroll
    • 1
  • Anna K. Veluz-Wilkins
    • 1
  • Brian Hitsman
    • 1
    Email author
  1. 1.Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoUSA

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