5 As of Tobacco Cessation

  • Ask: Ask all patients about tobacco use at every visit and record their status

  • Assess: Ask if tobacco user is willing to quit within the next 30 days

  • Advice: Advise in a clear, strong, & personalized manner every tobacco and non-tobacco users to remain tobacco-free

  • Assist: Help all tobacco users to stop based on their willingness to quit with a quit plan

  • Arrange: Schedule follow-up contact, either in person or by telephone

Videos

Smoking cessation counseling: https://youtu.be/Oce0qXiUYBM

Podcasts

#252 Smoking Cessation Unfiltered - The Curbsiders

Apps

App for patients to help with quit attempt: iCanQuitPlus on the App Store

Toolkit

Rx for Change: Implementation Toolkit

  • Drug interactions with smoking table 

  • Caffeine levels increase ~56% upon quitting smoking  

  • Pharmacologic product guide 

Articles

Smoking Cessation Interventions | AAFP

Pharmacological interventions for smoking cessation: an overview and network meta-analysis - PubMed

  • Comparison of interventions for smoking cessation (Odds ratio (95% CI)

    • Nicotine gum vs Placebo 1.7 (1.5-1.9) 

    • Bupropion SR vs Placebo 1.9 (1.6-2.1) 

    • Nicotine patch vs Placebo 1.9 (1.7-2.1) 

    • Other NRT vs Placebo 2.0 (1.8-2.4) 

    • Combination NRT vs Placebo 2.7 (2.1-3.7) 

    • Varenicline vs Placebo 2.9 (2.4-3.5) 

Neuropsychiatric safety and efficacy of varenicline, bupropion, and nicotine patch in smokers with and without psychiatric disorders (EAGLES): a double-blind, randomised, placebo-controlled clinical trial - The Lancet

  • The study did not show a significant increase in neuropsychiatric adverse events attributable to varenicline or bupropion relative to nicotine patch or placebo 

Psilocybin or Nicotine Patch for Smoking Cessation: A Pilot Randomized Clinical Trial - PubMed

  • 1 dose of psilocybin with manualized CBT significantly increased long-term abstinence compared with nicotine patch treatment with CBT.

    • At 6-month follow-up, 17 participants receiving psilocybin (40.5%) exhibited biochemically verified prolonged abstinence compared with 4 participants using the nicotine patch (10.0%) (odds ratio, 6.12; 95% CI, 1.99-23.26; P = .003)

    • 22 participants receiving psilocybin (52.4%) exhibited biochemically verified 7-day point prevalence abstinence compared with 10 participants using the nicotine patch (25.0%) (odds ratio, 3.30; 95% CI, 1.32-8.70; P = .01)

    • No serious adverse events were attributed to psilocybin or nicotine patch

Lung Cancer Screening

Recommendation: Lung Cancer: Screening | United States Preventive Services Taskforce

  • Adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years