On Sept. 22, the U.S. Preventive Services Task Force (USPSTF) released its final recommendation statement(www.uspreventiveservicestaskforce.org) on screening for and encouraging smoking cessation in adults, including pregnant women. In short, the task force recommends that physicians ask all adults about tobacco use and advise and assist those who smoke to quit using appropriate cessation aids.
“Smoking cessation is tough, but clinicians and patients have a variety of evidence-based interventions to choose from. Clinicians should ask their patients if they smoke and work together to determine the most appropriate way to help them quit,” said USPSTF member Francisco Garcia, M.D., M.P.H., in a news release.(www.uspreventiveservicestaskforce.org)
The task force reviewed evidence(www.uspreventiveservicestaskforce.org) on smoking cessation interventions and recommended that for nonpregnant adults who smoke, physicians should offer behavioral therapy and FDA-approved medications, including nicotine-replacement therapy, alone or in combination (A recommendation).(www.uspreventiveservicestaskforce.org)
For pregnant women, the USPSTF recommended only behavioral interventions (A recommendation) because not enough evidence was available to assess the benefits and harms of pharmacotherapeutic interventions for this population (I recommendation).
- The U.S. Preventive Services Task Force has released its final recommendation on smoking cessation in adults and recommends that physicians offer patients who smoke a variety of cessation aids.
- For pregnant women, the USPSTF recommends behavioral interventions only because not enough evidence exists to assess the benefits and harms of pharmacotherapeutic interventions in these patients.
- There also wasn't enough evidence for the task force to assess the benefits and harms of using e-cigarettes for smoking cessation in adults.
There also wasn't enough evidence for the task force to assess the benefits and harms of using e-cigarettes for smoking cessation in adults (I recommendation).
This recommendation statement updates and is consistent with the USPSTF's 2009 recommendation but adds a review of evidence on electronic nicotine delivery systems (ENDS) -- or e-cigarettes -- which have become more widespread since the previous recommendation was released. But again, it found insufficient evidence to recommend for or against the use of ENDS for tobacco cessation.
The AAFP's newly released recommendation statement mirrors the USPSTF's guidance.
After the draft recommendation on this topic was issued in May, AAFP News spoke with Jennifer Frost, M.D., medical director for the AAFP Health of the Public and Science Division, who said that when she was working with patients who wanted to quit smoking, her recommendation depended on what they were willing or able to do.
"I discussed what their support system was and what their 'triggers' tended to be in order to come up with a plan that worked for them," she said. "I offered support through regular visits with me, counseling or participation with a support group. I also encouraged patients to take prescription medication to increase their success, although this was often not financially feasible due to lack of insurance coverage. And some patients felt strongly that they needed nicotine replacement, while others felt strongly about going 'cold-turkey.'"
Frost also said she hoped this recommendation would lead to pharmacotherapy becoming more routinely prescribed and behavioral interventions more widely available to help patients quit smoking.
Related AAFP News Coverage
Teens' E-cigarette Use May Spark Bigger Smoking Risk, Says NIH