Tobacco Abuse and Dependence

Sep 1, 2014 Issue
Electronic Cigarettes: Cautions and Concerns [Editorials]

E-cigarettes are gaining popularity as a novel approach to smoking cessation, but data regarding safety and effectiveness are lacking. Until there is further research into the benefits and risks of e-cigarettes, physicians should recommend more familiar alternatives to help their patients quit smoking.

Jun 1, 2014 Issue
Varenicline Plus Bupropion SR No Better Than Varenicline Alone for Tobacco Cessation [POEMs]

Combination therapy with varenicline and sustained-release bupropion was associated with a significantly higher prolonged abstinence rate compared with varenicline monotherapy at 12 weeks and 26 weeks in adult smokers attempting to quit. By 52 weeks, however, the difference was no longer statistically significant.

Mar 15, 2012 Issue
Promoting Smoking Cessation [Article]

Cigarette smoking causes significant morbidity and mortality in the United States. Physicians can use the five A’s framework (ask, advise, assess, assist, arrange) to promote smoking cessation. All patients should be asked about tobacco use and assessed for motivation to quit at every clinical encou...

Oct 1, 2011 Issue
Nicotine Receptor Partial Agonists for Smoking Cessation [Cochrane for Clinicians]

Compared with placebo, varenicline more than doubles the chances of successful long-term smoking abstinence. In head-to-head trials, varenicline appears to be at least as effective as nicotine replacement therapy and bupropion (Zyban). The most common adverse effect is nausea, which decreases over t...

Jul 15, 2011 Issue
Let Quitlines Assist You in Helping More Smokers Quit [Editorials]

Despite significant advances in pharmacotherapy and counseling techniques, tobacco use remains the leading cause of death in the United States, accounting for 443,000 premature deaths annually. Family physicians are in an ideal position to influence cessation rates because more than 70 percent of sm...

Mar 1, 2011 Issue
Stage-Based Interventions for Smoking Cessation [Cochrane for Clinicians]

Although providing stage-based smoking cessation interventions for those trying to quit appears to be more effective than not intervening at all, the evidence does not support tailoring interventions to a patient's perceived motivational stage of change.

Nov 15, 2010 Issue
Counseling and Interventions to Prevent Tobacco Use and Tobacco-Caused Disease in Adults and Pregnant Women: Reaffirmation Recommendation Statement [U.S. Preventive Services Task Force]

The U.S. Preventive Services Task Force (USPSTF) recommends that clinicians ask all adults about tobacco use and provide tobacco cessation interventions for those who use tobacco products.

Nov 15, 2010 Issue
Counseling and Interventions to Prevent Tobacco Use and Tobacco-Caused Disease in Adults and Pregnant Women [Putting Prevention into Practice]

Case study: A young married couple visits your office for their initial prenatal visit. They each smoke one pack of cigarettes daily.

Dec 1, 2009 Issue
Interventions to Help Patients Reduce or Eliminate the Use of Smokeless Tobacco [Cochrane for Clinicians]

Although the studies of behavior interventions were heterogeneous in this Cochrane review, behavior interventions such as mailings, oral or dental screenings, group discussions, workplace interventions, and telephone support showed the best evidence for smokeless tobacco cessation.

Feb 15, 2008 Issue
Reducing Tobacco Use in Adolescents [Article]

After steadily decreasing since the late 1990s, adolescent smoking rates have stabilized at levels well above national goals. Experts recommend screening for tobacco use and exposure at every patient visit, although evidence of improved outcomes in adolescents is lacking. Counseling should be provid...

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