An expert consensus decision pathway has been developed for tobacco cessation treatment; the report was published online Dec. 5 in the Journal of the American College of Cardiology.
Rajat S. Barua, M.D., Ph.D., from the University of Kansas School of Medicine in Kansas City, and colleagues brought together expert clinicians and a broad group of stakeholders from different professional societies and federal agencies to discuss the ongoing risk of tobacco and nicotine exposure and challenges associated with delivering smoking cessation therapy.
The authors note that for health care providers, the consistent delivery of tobacco cessation treatment remains a significant challenge. Clinicians and practices should establish a team-based care system that recognizes cigarette smoking as a chronic relapsing substance use disorder caused by nicotine addiction. The care team should ensure that during all clinical encounters, patients are asked about cigarette smoking and other tobacco product use. Tobacco product users should receive advice to stop use and be offered a brief intervention, including prescriptions for pharmacological smoking cessation aids and proactive referrals to evidence-based behavioral support. Former smokers should be monitored for possible relapse. Nonsmokers should be asked about exposure to secondhand smoke and encouraged to avoid exposure.
"The primary objective of this document is to provide a framework for the many decisions required in delivering smoking cessation therapy in [the] clinical practice setting," the authors write. "No guideline, pathway, or algorithm should ever supersede clinical judgments."
Several authors disclosed financial ties to the pharmaceutical industry; two authors acted as expert witnesses in tobacco litigation.