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Tobacco

Lori A. Pbert, Ph.D.; Judith K. Ockene, Ph.D., M.Ed.

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Assessment of and intervention with the smoker are closely integrated because gathering information about the person's smoking history and current smoking patterns increases self-awareness in a way that facilitates behavior change. To guide the clinician, the U.S. Public Health Service (PHS) has developed the "Treating Tobacco Use and Dependence" clinical practice guideline (Fiore et al. 2000). This guideline provides an assessment and intervention model for the treatment of nicotine dependence, as well as evidence-based treatment strategies that incorporate the National Cancer Institute's "five As" strategies: Ask, Advise, Assess, Assist, and Arrange follow-up. In the model proposed by the PHS (Figure 16C–1), it is recommended that smoking status be routinely assessed and documented at every clinical contact (Ask). All current smokers should be given clear, strong, and personalized advice to stop smoking (Advise) and at each contact assessed for their willingness to quit (Assess). For those smokers who are willing to quit, further assessment should occur, taking into account the physiological, psychological, and social factors maintaining their smoking behavior, and brief intervention with follow-up should be provided (Assist and Arrange). When appropriate, the clinician may refer the patient for more intensive treatment. Smokers who are not willing to quit should receive a brief motivational intervention to facilitate motivation and future quitting efforts. Additionally, individuals who have recently quit should be provided intervention to prevent relapse.

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Figure 16C–1. Model for nicotine dependence assessment and treatment.Source. Adapted from Fiore MC, Bailey WC, Cohen SJ, et al. "Treating Tobacco Use and Dependence." Clinical Practice Guideline. Rockville, MD, U.S. Department of Public Health and Human Services, Public Health Service, Agency for Healthcare Research and Quality, June 2000. This document is in the public domain and may be used and reprinted without special permission.
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Table 16C–1. Strategies for assisting smokers who are ready to quit
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Figure 16C–2. Fagerstrom Test for Nicotine Dependence.
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Table 16C–2. First-line medications for treating nicotine dependence 
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Table 16C–3. Common elements of practical counseling (problem-solving skills training)
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Table 16C–4. Potential responses to patient-reported problems that threaten abstinence during prescriptive relapse prevention

References

Ascher J, Cole J, Colin J-N, et al: Bupropion: a review of its mechanism of antidepressant activity. J Clin Psychiatry 56:395–401, 1995
[PubMed]
 
Bandura A: Principles of Behavior Modification. New York, Holt, Rinehart, & Winston, 1969
 
Bandura A: Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev 84:191–215, 1977
[PubMed]
 
Bock B, Marcus B, King T, et al: Exercise effects on withdrawal and mood among women attempting smoking cessation. Addict Behav 24:399–410, 1999
[PubMed]
 
DiClemente C, Prochaska J, Fairhurst S, et al: The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. J Consult Clin Psychol 59:295–304, 1991
[PubMed]
 
Fiore M, Smith S, Jorenby D, et al: The effectiveness of the nicotine patch for smoking cessation: a meta-analysis. JAMA 271:1940–1947, 1994
[PubMed]
 
Fiore M, Bailey W, Cohen S, et al: Smoking Cessation: Clinical Practice Guideline No. 18. Rockville, MD, U.S. Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research, 1996
 
Fiore MC, Bailey WC, Cohen SJ, et al: Treating Tobacco Use and Dependence: Clinical Practice Guideline. Rockville, MD, U.S. Department of Health and Human Services, Public Health Service, Agency for Healthcare Research and Quality, 2000
 
Foulds J: The neurological basis for partial agonist treatment of nicotine dependence: varenicline. Int J Clin Pract 60:571–576, 2006
[PubMed]
 
Foxx R, Brown R: Nicotine fading and self-monitoring for cigarette abstinence or controlled smoking. J Appl Behav Anal 12:111–125, 1979
[PubMed]
 
Froom P, Melamed S, Benbasal J: Smoking cessation and weight gain. J Fam Pract 46:460–464, 1998
[PubMed]
 
Goldfried M, Davison G: Clinical Behavior Therapy. New York, Holt, Rinehart, & Winston, 1976
 
Gourlay S, Benowitz N: Arteriovenous differences in plasma concentration of nicotine and catecholamines and related cardiovascular effects after smoking, nicotine nasal spray, and intravenous nicotine. Clin Pharmacol Ther 62:453–463, 1997
[PubMed]
 
Grunberg N: The effects of nicotine and cigarette smoking on food consumption and taste preferences. Addict Behav 7:317–331, 1982
[PubMed]
 
Heatherton T, Kozlowski L, Frecker R, et al: The Fagerstrom Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire. Br J Addict 86:1119–1127, 1991
[PubMed]
 
Hofstetter A, Schutz Y, Jequier E, et al: Increased 24-hours energy expenditure in cigarette smokers. N Engl J Med 314:79–82, 1986
[PubMed]
 
Hughes J: Combined psychological and nicotine gum treatment for smoking: a critical review. J Subst Abuse 3:337–350, 1991
[PubMed]
 
Hughes J: Treatment of nicotine dependence: is more better? JAMA 274:171–181, 1995
 
Hughes J: Dependence on and abuse of nicotine replacement: an update, in Nicotine Safety and Toxicity. Edited by Benowitz N. New York, Oxford University Press, 1998, pp 147–160
 
Hughes J, Hatsukami D: The nicotine withdrawal syndrome: a brief review and update. International Journal of Smoking Cessation 1:21–26, 1992
 
Hughes J, Fiester S, Goldstein M, et al: American Psychiatric Association Practice Guideline for the treatment of patients with nicotine dependence. Am J Psychiatry 153:S1–S31, 1996
 
Hughes J, Goldstein M, Hurt R, et al: Recent advances in the pharmacotherapy of smoking. JAMA 281:72–76, 1999
[PubMed]
 
Irvin J, Bowers C, Dunn M, et al: Efficacy of relapse prevention: a meta-analytic review. J Consult Clin Psychol 67:563–570, 1999
[PubMed]
 
Killen J, Fortmann S, Newman B, et al: Evaluation of a treatment approach combining nicotine gum with self-guided behavioral treatments for smoking relapse prevention. J Consult Clin Psychol 58:85–92, 1990
[PubMed]
 
Klesges R, Meyers A, Klesges L, et al: Smoking, body weight and their effects on smoking behavior: a comprehensive review of the literature. Psychol Bull 106:204–230, 1989
[PubMed]
 
Law M, Tang J: An analysis of the effectiveness of interventions intended to help people stop smoking. Arch Intern Med 155:1933–1941, 1995
[PubMed]
 
Lichtenstein E, Brown A: Current trends in the modification of cigarette dependence, in International Handbook of Behavior Modification and Therapy. Edited by Bellack A, Hersen M, Kazdin A. New York, Plenum, 1985, pp 575–612
 
Marlatt G, Gordon J: Determinants of relapse: implications for the maintenance of behavior change, in Behavioral Medicine: Changing Health Lifestyles. Edited by Davidson P, Davidson S. New York, Brunner/Mazel, 1980, pp 410–452
 
Massachusetts Department of Public Health: 1997 Cigarette Nicotine Disclosure Report as Required by Massachusetts General Laws. Chapter 307B, Report No CMR660.000, January 16, 1998
 
Ockene JK, Adams A, Pbert L, et al: The physician-delivered smoking intervention project (PDSIP): factors that determine how much the physician intervenes with smokers. J Gen Intern Med 9(7):379–384, 1994
[PubMed]
 
Ockene J, Emmons K, Mermelstein R, et al: Relapse and maintenance issues for smoking cessation. Health Psychol 19:17–31, 2000
[PubMed]
 
Perkins K: Metabolic effects of cigarette smoking. J Appl Physiol 72:401–409, 1992
[PubMed]
 
Schuh K, Schuh L, Henningfield J, et al: Nicotine nasal spray and vapor inhaler: abuse liability assessment. Psychopharmacology 130:352–361, 1997
[PubMed]
 
Schwartz J: Methods of smoking cessation. Med Clin North Am 76:451–476, 1992
[PubMed]
 
Shiffman S: Efficacy of a nicotine lozenge for smoking cessation. Arch Intern Med 162:1267–1276, 2002
[PubMed]
 
Sutherland G, Stapleton J, Russell M, et al: Randomized controlled trial of nasal nicotine spray in smoking cessation. Lancet 340:324–329, 1992
[PubMed]
 
U.S. Department of Health and Human Services: The Health Benefits of Smoking Cessation: A Report of the Surgeon General (DHHS Publ No CDC 90-8416). Atlanta, GA, Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1990, pp 580–616
 
Velicer W, Fava J, Prochaska J, et al: Distribution of smokers by stage in three representative samples. Prev Med 48:401–411, 1995
 
Wack J, Rodin L: Smoking and its effects on body weight and the systems of caloric regulation. Am J Clin Nutr 35:366–380, 1982
[PubMed]
 
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