Evidence Reports
All patients should be asked if they use tobacco and should have their tobacco- use status documented on a regular basis. Evidence has shown that this significantly increases rates of clinician intervention.
Strength of evidence: A
Clinic screening systems such as expanding the vital signs to include tobacco- use status, or the use of other reminder systems such as chart stickers or computer prompts are essential for the consistent assessment, documentation, and intervention with tobacco use.
Strength of evidence: B
All physicians should strongly advise every patient who smokes to quit because evidence shows that physician advice to quit smoking increases abstinence rates.
Strength of evidence: A
All clinicians should strongly advise their patients who use tobacco to quit. Although studies have not independently addressed the impact of advice to quit by all types of nonphysician clinicians, it is reasonable to believe that such advice is effective in increasing their patients' long-term quit rates.
Strength of evidence: B
All patients attempting to quit should be encouraged to use effective pharmacotherapies for smoking cessation except in the presence of special circumstances.
Strength of evidence: A
Evidence-based Recommendations
Bupropion SR is an efficacious smoking cessation treatment that patients should be encouraged to use.
Strength of evidence: A
Nicotine gum is an efficacious smoking cessation treatment that patients should be encouraged to use.
Strength of evidence: A
The nicotine inhaler is an efficacious smoking cessation treatment that patients should be encouraged to use.
Strength of evidence: A
Nicotine nasal spray is an efficacious smoking cessation treatment that patients should be encouraged to use.
Strength of evidence: A
The nicotine patch is an efficacious smoking cessation treatment that patients should be encouraged to use.
Strength of evidence: A
Combining the nicotine patch with a self-administered form of nicotine replacement therapy (either the nicotine gum or nicotine nasal spray) is more efficacious than a single form of nicotine replacement, and patients should be encouraged to use such combined treatments if they are unable to quit using a single type of first-line pharmacotherapy.
Strength of evidence: B
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