Putting Prevention into Practice

An Evidence-Based Approach

Behavioral and Pharmacotherapy Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Women

 

Am Fam Physician. 2016 May 15;93(10):861-862.

  Related U.S. Preventive Services Task Force Recommendation Statement: Behavioral and Pharmacotherapy Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Women: Recommendation Statement.

Case Study

A 40-year-old woman presents for a routine antepartum visit. She is 20 weeks pregnant and smokes half a pack of cigarettes per day despite efforts to quit. She has no other concerns, and her physical examination findings are normal. The patient asks if your clinic offers services to help with tobacco smoking cessation and if she should try using e-cigarettes to stop smoking.

Case Study Questions

  1. The U.S. Preventive Services Task Force (USPSTF) found convincing evidence that achievement of tobacco cessation in pregnant women results in which one of the following outcomes?

    • A. Improved infant Apgar scores.

    • B. Increased infant birth weight.

    • C. Increased infant head circumference at birth.

    • D. Decreased rates of cesarean delivery.

  2. Based on the USPSTF recommendation statement, which one of the following tobacco smoking cessation interventions should you recommend to this patient?

    • A. Behavioral interventions and pharmacotherapy combined, because there is convincing evidence that these methods improve achievement of tobacco smoking cessation in pregnant women.

    • B. Electronic nicotine delivery system (ENDS), because there is adequate evidence that this method alone improves achievement of tobacco smoking cessation in pregnant women.

    • C. Pharmacotherapy, because there is adequate evidence that its harms are small to none in pregnant women.

    • D. Behavioral interventions, because there is convincing evidence that this method alone improves achievement of tobacco smoking cessation in pregnant women.

  3. Which of the following statements about tobacco cessation inte

Author disclosure: No relevant financial affiliations.

SOURCES

Behavioral and pharmacotherapy interventions for tobacco smoking cessation in adults, including pregnant women: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2015;163(8):622–634.

Patnode CD, Henderson JT, Thompson JH, Senger CA, Fortmann SP, Whitlock EP. Behavioral counseling and pharmacotherapy interventions for tobacco smoking cessation in adults, including pregnant women: a review of reviews for the U.S. Preventive Services Task Force. Ann Intern Med. 2015;163(8):608–621.

This PPIP quiz is based on the recommendations of the USPSTF. More information is available in the USPSTF Recommendation Statement and the supporting documents on the USPSTF website (http://www.uspreventiveservicestaskforce.org). The practice recommendations in this activity are available at http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/tobacco-use-in-adults-and-pregnant-women-counseling-and-interventions1.

This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.

A collection of Putting Prevention into Practice published in AFP is available at http://www.aafp.org/afp/ppip.


 

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