Putting Prevention into Practice
An Evidence-Based Approach
Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Persons
Am Fam Physician. 2021 Jun 15;103(12):753-754.
Author disclosure: No relevant financial affiliations.
A 27-year-old patient, R.C., with a history of generalized anxiety disorder presents for a wellness examination. R.C. previously smoked a pack of cigarettes per day but has cut down to half a pack per day and started using electronic cigarettes (e-cigarettes) and is interested in eventually quitting the use of tobacco products. R.C. has no other significant medical history, takes no medications, and has an intrauterine device (IUD) for contraception. Physical examination findings are within normal limits.
Case Study Questions
1. Based on the U.S. Preventive Services Task Force (USPSTF) recommendation, which of the following behavioral interventions are effective options for R.C.?
A. Nurse advice, which includes a verbal stop smoking message, print materials, and a one-month follow-up visit.
B. Hypnotherapy for a minimum of 120 minutes, delivered over four or more sessions.
C. Group-based counseling facilitated by a smoking cessation specialist, delivered over six sessions.
D. Telephone counseling during scheduled calls, following an initial call to a smoking quit line, to take place over four months.
2. According to the USPSTF, which one of the following statements about the use of e-cigarettes for tobacco cessation is correct and should be shared with your patient?
A. e-Cigarettes have been definitively shown to increase tobacco cessation in adults.
B. e-Cigarettes are typically used only in the short term when used for tobacco cessation.
C. The harms associated with e-cigarette use are well known and minor because nicotine is the only toxic substance emitted.
D. The current evidence is insufficient to assess the balance of benefits and harms of e-cigarettes for tobacco cessation in adults, including pregnant persons.
3. R.C. is interested in IUD removal because R.C. and their partner would like to conceive. Based on the USPSTF recommendation, which one of the following statements about pharmacotherapy for tobacco cessation in pregnant persons is correct?
1. Krist AH, Davidson KW, Mangione CM, et al. Interventions for tobacco smoking cessation in adults, including pregnant persons: US Preventive Services Task Force recommendation statement. JAMA. 2021;325(3):265–279.
2. Patnode CD, Henderson JT, Coppola EL, et al. Interventions for tobacco cessation in adults, including pregnant persons: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2021;325(3):280–298.
This PPIP quiz is based on the recommendations of the USPSTF. More information is available in the USPSTF Recommendation Statement and supporting documents on the USPSTF website (https://www.uspreventiveservicestaskforce.org). The practice recommendations in this activity are available at https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/tobacco-use-in-adults-and-pregnant-women-counseling-and-interventions.
This series is coordinated by Kenny Lin, MD, MPH, deputy editor.
A collection of Putting Prevention into Practice published in AFP is available at https://www.aafp.org/afp/ppip.
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