Objectives. Disclosure. Prevalence of Tobacco Use. Smoking Cessation Pharmacotherapy 3/2/2016.
|
|
- Sarah Floyd
- 6 years ago
- Views:
Transcription
1 Smoking Cessation Pharmacotherapy Melodie Merzier-Michel PGY-1 Pharmacy Resident Memorial Regional Hospital Objectives Discuss the prevalence of tobacco use in the United States (U.S.) Describe the health risks associated with smoking Describe the health benefits of smoking cessation Define smoking cessation Recognize the 5 A s to promote smoking cessation Highlight the role of nicotine replacement therapy in smoking cessation Identify the use of other pharmacotherapies in smoking cessation 3 Disclosure The author of this presentation has nothing to disclose concerning possible financial or personal relationships with commercial entities that may have a direct or indirect interest in the subject matter of this presentation. Prevalence of Tobacco Use In 2014, nearly 17 of every 100 U.S. adults 18 years or older (16.8%) or an estimated 40 million adults in the U.S., smoked cigarettes Each year there are 480,000 deaths attributed to smoking in the U.S Largest avoidable source of mortality 2 Economic Facts About U.S Tobacco Production and Use. Centers for Disease Control and Prevention. 4 1
2 Prevalence of Tobacco Use Second Hand Smoke Each day 4,000 minors, ages 12 to 17, smoke their first cigarette Approximately 1,200 children and adolescents become daily cigarette smokers More than 16 million Americans live with a smoking-related disease Smoke that has been exhaled, or breathed out, from burning tobacco products, such as: Cigarettes Cigars Pipes Economic Facts About U.S Tobacco Production and Use. Centers for Disease Control and Prevention. 5 Second Hand Smoke. Centers for Disease Control and Prevention. Updated Prevalence of Tobacco Use Second Hand Smoke Cigarettes account for greater than 90% of tobacco use Smokeless tobacco accounts for less than 5% Pipes and cigars account for less than 1% Accounts for approximately 2,500,000 deaths in nonsmokers Results in nearly 34,000 heart disease deaths each year Associated with more than 7,300 lung cancerrelated deaths each year Stead LF et al. Nicotine replacement therapy for smoking cessation. American Psychiatric Association, (2000). Diagnostic and Statistical Manual for Mental Disorders - V 6 Second Hand Smoke. Centers for Disease Control and Prevention. Updated
3 Costs of Tobacco Use What s in a Cigarette? $96 billion dollars per year in direct medical expenses $156 billion dollars lost in work wages $193 billion dollars in annual health-related economic losses $300 billion dollars in total economic cost of smoking Economic Facts About U.S Tobacco Production and Use. Centers for Disease Control and Prevention. 9 Stead LF et al. Nicotine replacement therapy for smoking cessation 11 Health Consequences of Smoking Health Consequences of Smoking Respiratory Effects Cardiovascular Effects Reproductive effects Cancer Smoking Other Diseases 10 Health Effects of Cigarette Smoking. Centers for Disease Control and Prevention
4 Health Consequences of Smoking Assessment Tools for Tobacco Dependence Fagerstrom Tolerance Questionnaire (FTQ) Fagerstrom Test for Nicotine Dependence (FTND) Diagnostic and Statistical Manual (DSM) Cigarette Dependence Scale (CDS) Nicotine Dependence Syndrome Scale (NDSS) Wisconsin Inventory of Smoking Dependence Motives (WISDM) 13 Piper et al. (2006). Nicotine & Tobacco Research 15 Tobacco Dependence Nicotine Addiction Smoking within 30 minutes of awakening Smoking more than 20 cigarettes per day Awaking at night to smoke American Psychiatric Association, (2000). Diagnostic and Statistical Manual for Mental Disorders V
5 Nicotine Withdrawal Symptoms 5 A s Model for Treating Tobacco Use and Dependence Anxiety Craving Cognitive and attention deficits Depression Decreased heart rate Increased appetite or weight gain Irritability, frustration, anger Sleep disturbances ASK ADVISE ASSESS ASSIST ARRANGE American Psychiatric Association, (2000). Diagnostic and Statistical Manual for Mental Disorders V Tobacco Dependence Methods for Enhancing Motivation to Quit The 5 R s 70 % of adult tobacco users report wanting to quit each year 44% of adult tobacco users report they try to quit each year Only 4-7% of tobacco users who attempt to quit are successful Relevance What s the most important reason for you to consider quitting? Risks What are the negative things you think about smoking? Rewards What are the benefits you may have if you stop smoking? Roadblocks What barriers do you have to quitting tobacco? Repetition Many people need 7 to 10 attempts before they are successful Lavinghouze et. al. Trends in Quit Attempts Among Cigarette Smokers. MMWR, October 16, Fiore et al. (2008). Treating Tobacco use and Dependence
6 Who Should Receive Treatment? All tobacco users trying to quit, except: Contraindication to pharmacotherapy Specific populations with insufficient evidence of effectiveness Adolescents Light smokers (<10 cigarettes a day) Pregnant women Smokeless tobacco users 21 Fiore et al. (2008). Treating Tobacco use and Dependence. 23 Considerations for Treatment Selection Treatment Adverse effects Cost Patient characteristics History of depression Weight gain concerns Breastfeeding Patient preference Precautions and contraindications Previous patient experience 22 Fiore et al. (2008). Treating Tobacco use and Dependence 24 6
7 Second Line Agents Pharmacotherapy Non FDA-approved Clonidine (Catapres, Catapres-TTS ) Nortriptyline (Pamelor ) 25 Fiore et al. (2008). Treating Tobacco use and Dependence 27 First Line Agents Nicotine Replacement Therapy (NRT) FDA-approved Nicotine Replacement Therapy (NRT) Nicotine Transdermal Patch (OTC) Nicotine Gum (OTC) Nicotine Lozenge (OTC) Nicotine Inhaler (Rx) Nicotine Nasal Spray (Rx) Buproprion SR (Zyban, Wellbutrin SR ) (Rx) Varenicline (Chantix ) (Rx) Fiore et al. (2008). Treating Tobacco use and Dependence 26 Fiore et al. (2008). Treating Tobacco use and Dependence Silagy, C., et al. (2004),. Cochrane Database Syst Rev CD
8 Nicotine Replacement Therapy (NRT) NRT Precautions Patch Options Gum, Inhaler, Lozenge Nasal Spray Recent MI (within 2 weeks) Serious underlying arrhythmias Serious or worsening angina pectoris Pregnancy category D Breastfeeding Adolescents (<18 years) Slow Absorption Intermediate Absorption Fast Absorption Fiore et al. (2008). Treating Tobacco use and Dependence Silagy, C., et al. (2004),. Cochrane Database Syst Rev CD Nicotine Containing Products Plasma Concentrations Efficacy of NRT Rx for Change: Clinician-Assisted Tobacco Cessation. San Francisco, CA: The Regent of the University of California, University of Southern California, and Western University of Health Sciences.; All NRT forms increase quit rates at 6-12 months by 50-70% compared to placebo No significant difference between NRT forms 4mg gum is more effective in highly dependent smokers Higher dose patches do not show additional benefit The intensity of additional advice and support does not increase the effectiveness of NRT A combination of NRT products is more effective than one product alone Fiore et al. (2008). Treating Tobacco use and Dependence Silagy, C., et al. (2004),. Cochrane Database Syst Rev CD Stead et al. (2008). Cochrane Database Syst Rev 2008(1) 32 8
9 Nicotine Transdermal Patch (NicoDerm CQ, etc.) Product NicoDerm CQ or generic 7mg, 14mg, 21mg (24-hour release) Adverse Effects Local skin reactions Headache Sleep disturbances Nicotine Transdermal Patch (NicoDerm CQ, etc.) Advantages Once daily dosing improves adherence Less visible Can be used in combination with other agents Delivers consistent nicotine levels over 24 hours Disadvantages Cannot be titrated to acutely manage withdrawal symptoms Not recommended for use in patients with dermatologic conditions (e.g., psoriasis, eczema, atopic dermatitis) Allergic reactions to adhesive Nicotine Transdermal Patch (NicoDerm CQ, etc.) Dosing If >10 cigarettes/day: 21 mg/dayx 4-6 weeks 14 mg/dayx 2 weeks 7 mg/day x 2 weeks If <10 cigarettes/day: 14 mg/day x 6 weeks 7 mg/day x 2 weeks Counseling Points Worn for 24hr (16hrif having trouble sleeping) Apply upon awakeningon quit date Nicotine Gum (Nicorette, etc.) Product Nicorette or generic 2mg, 4mg Original, cinnamon, fruit, and mint flavors Adverse Effects Dyspepsia Sore mouth Hiccups Jaw ache Hypersalivation 4 weeks, then 2 weeks, then 2 weeks
10 Nicotine Gum (Nicorette, etc.) Nicotine Lozenge (Commit, Nicorette ) Dosing < 25 cigarettes/day: 2mg 25 cigarettes/day: 4mg 1 gum every 1-2 hours x 6 weeks 1 gum every 2-4 hours x 2 weeks 1 gum every 4-8 hours x 3 weeks Maximum 24 pieces/day Use up to 12 weeks Counseling Points Chew each piece slowly Park between cheek and gum when peppery or tingling sensation appears (~15-30 chews) Resume chewing when tingling fades Park in different areas of mouth Avoid acidic beverages15 minutes before and after chewing Product Commit or generic 2mg, 4mg Cherry or mint flavor Nausea Sore throat Hiccups Heartburn Headache Flatulence Insomnia Adverse Effects Nicotine Gum (Nicorette, etc.) Nicotine Lozenge (Commit, Nicorette ) Advantages Oral substitute for tobacco Titrated to manage withdrawal symptoms Used in combination with other agents to manage craving Variations in flavors Disadvantages Frequent dosing can compromise adherence Proper chewing technique is necessary for effectiveness and to minimize adverse effects Dosing 1 st cigarette < 30 minutes after waking: 4mg 1 st cigarette > 30 minutes after waking: 2mg Weeks 1-6: 1 every 1-2 hours Weeks 7-9: 1 every 2-4 hours Weeks 10-12: 1 every 4-8 hours Maximum 20 lozenges/day Counseling Points Allow to dissolve slowly (20 30 minutes) Nicotine release may cause a warm, tingling sensation Do not chew or swallow Rotate to different areas of the mouth No food or beverages 15 minutes before or during use Used for at least 12 weeks
11 Nicotine Lozenge (Commit, Nicorette ) Nicotine Inhaler (Nicotrol Inhaler ) Advantages Can serve as an oral substitute for tobacco Can be titrated to manage withdrawal symptoms Can be used in combination with other agents to manage craving Disadvantages Frequent dosing can compromise adherence Gastrointestinal side effects Dosing 6 16 cartridges/day Individualize dosing Initially use 1 cartridge every 1 2 hours Use for up to 6 months Counseling Points Continuous puffing for 20 minutes Nicotine is depleted after 20 minutes of active puffing Inhale into back of throat or puff in short breaths Do NOT inhale into the lungs (like a cigarette) but puff as if using a pipe Open cartridge retains potency for up to 24 hours No food or beverages 15 minutes before or during use Nicotine Inhaler (Nicotrol Inhaler ) Nicotine Inhaler (Nicotrol Inhaler ) Product Nicotrol Inhaler or generic 10 mg cartridge delivers 4mg inhaled nicotine vapor Adverse Effects Local irritation of mouth and throat Cough Headache Dyspepsia Rhinitis Advantages Can be titrated to manage withdrawal symptoms Mimics hand-to-mouth ritual of smoking Can be used in combination with other agents to manage cravings Disadvantages Frequent dosing can compromise adherence Cartridges might be less effective in cold environments Throat and mouth irritation Caution in patients with bronchospastic disease
12 Nicotine Nasal Spray (Nicotrol NS ) Nicotine Nasal Spray (Nicotrol NS ) Product Nicotrol NS or generic Metered spray 10mg/ml aqueous nicotine solution Adverse Effects Nasal irritation Nasal congestion Transient changes in taste and smell Headache Cough Sneezing Advantages Can be titrated to manage withdrawal symptoms Can be used in combination with other agents to manage situational urges Disadvantages Frequent dosing can compromise adherence Development of dependence Patients with chronic nasal disorders orreactive airway disease should not use spray Nose and throat irritation Nicotine Nasal Spray (Nicotrol NS ) Bupropion SR (Zyban ) Dosing 1 2 doses/hour (8 40 doses/day) One dose = 2 sprays (one in each nostril); each spray delivers 0.5 mg of nicotine to the nasal mucosa Maximum: 5 doses/hour or 40 doses/day Use up to 3-6 months Counseling Points Prime prior to use Tilt head back slightly Do not sniff, swallow, or inhale through the nose as spray is being administered Wait 2 to 3 minutes before blowing nose Atypical antidepressant which inhibits dopamine and norepinephrine reuptake and possibly acts as a nicotinic antagonist Contraindications Seizure disorder Current or prior diagnosis of bulimia/anorexia Abrupt discontinuation of alcohol or sedatives/benzodiazepines MAO inhibitors in preceding 14 days 46 Hughes J et al (2004). Cochrane Database Syst Rev: CD Zyban (Summary of Product Characteristics) GlaxoSmithKline 48 12
13 Bupropion SR (Zyban ) Bupropion SR (Zyban ) Precautions Hepatic impairment Concomitant therapy with medications/conditions known to lower the seizure threshold History of seizure Pregnancy category C BLACK-BOXED WARNING for neuropsychiatric symptoms Product Zyban or bupropion SR 150mg (sustained-release tablet) Adverse Effects Insomnia Dry mouth Nervousness/difficulty concentrating Nausea Dizziness Constipation 49 Hughes J et al (2004). Cochrane Database Syst Rev: CD Zyban (Summary of Product Characteristics) GlaxoSmithKline 51 Efficacy of Bupropion SR (Zyban ) Bupropion SR (Zyban ) Combining bupropion SR with an NRT has been shown to increase short-term smoking abstinence rates Combination of bupropion SR and nicotine patch have shown no significant increase for long-term (>6months) abstinence rates compared to nicotine patch alone Dosing 150 mg every morning x 3 days, then 150 mg twice a day Do not exceed 300 mg/day Begin therapy 1 2 weeks prior to quit date Counseling Points Allow at least 8 hours between doses Avoid bedtime dosing to minimize insomnia Croghan IT et al. (2007) Randomized comparison of a nicotine inhaler and bupropion for smoking cessation and relapse prevention.. 2Piper ME et al (2009) Arch Gen Psych Ebbert et al. (2010). Drugs 2010; 70(6): Hughes J et al (2004). Cochrane Database Syst Rev: CD Zyban (Summary of Product Characteristics) GlaxoSmithKline 52 13
14 Bupropion SR (Zyban ) Varenicline (Chantix ) Advantages Twice daily oral dosing is associated with fewer adherence problems Might delay weight gain Beneficial in patients with depression Can be used in combination with NRT agents Disadvantages Increased seizure risk Several contraindications and precautions Patients should be monitored for potential neuropsychiatric symptoms Hughes J et al (2004). Cochrane Database Syst Rev: CD Zyban (Summary of Product Characteristics) GlaxoSmithKline Title Randomized trial of nicotine replacement therapy (NRT), bupropion and NRT plus bupropion for smoking cessation: effective in clinical practice Outcomes Self-reported cessation over 6 months with biochemical verification at 1 and 6 months Methods Open-label randomized controlled trial with 6 month follow up Participants: smokers (n=1071), NRT product of participant choice (n=418), bupropion (n=409), NRT plus bupropion (n=244) Results Abstinence rates for bupropion (27.9%) and NRT (24.2%) were not significantly different Abstinence rates for bupropion and NRT (24.2%) was similar to monotherapy Bupropion appears more beneficial than NRT in those with a history of depression (29.8 versus 18.5%) Conclusion Evidence has shown that bupropion is more beneficial than nicotine replacement therapy for smokers with a history of depression There is no difference in smoking cessation effectiveness among bupropion, nicotine replacement therapy, or their combination Stapleton J et al. Addict. 2013;108(12): Efficacy of Varenicline (Chantix ) Existing data indicates that varenicline is more effective than bupropion and some forms of NRT in achieving abstinence, and is recommended for use as a first line therapy Zwar N, et al (2007) Smoking cessation pharmacotherapy: An update for health professionals
15 Varenicline (Chantix ) Varenicline (Chantix ) Precautions Use with caution and lower dosage in patients with CrCl<30 ml/min or those on dialysis Pregnancy category C Cardiovascular events BLACK BOX WARNING for neuropsychiatric symptoms Contraindications Hypersensitivity to varenicline Dosing Day 1-3: 0.5mg daily Day 4-7: 0.5mg twice daily Day 8-end of treatment: 1mg twice a day Counseling Points Take after eating with full glass of water to decrease nausea Take second pill at dinner rather than bedtime to reduce insomnia Cahill K et al (2007). Cochrane Database Syst Rev: CD Varenicline (Chantix) Package insert. Accessed January 19, Varenicline (Chantix ) Varenicline (Chantix ) Product Adverse Effects Chantix 0.5mg and 1mg Nausea Sleep disturbance Vivid/strange dreams Headaches Constipation Vomiting Neuropsychiatric symptoms Advantages Twice daily oral dosing is associated with fewer adherence problems Different mechanism of action for patients who have failed other agents Disadvantages Should be taken with food or a full glass of water to reduce the incidence of nausea Requires monitoring for potential neuropsychiatric and cardiovascular symptoms Varenicline (Chantix) Package insert. Accessed January 19, Varenicline (Chantix) Package insert. Accessed January 19,
16 Clonidine (Catapres, Catapres-TTS ) Title Efficacy of vareniclinecombined with nicotine replacement therapy vs. varenicline alone for smoking cessation Outcomes Primary outcome was the 4-week abstinence rates from smoking for weeks 9 through 12 of treatment Secondary outcome included point prevalence abstinence at 6 months, continuous abstinence rate from weeks 9 through 24, and adverse events Mechanism of Action Precautions Adverse Effects Stimulates alpha-2 adrenoreceptorsin the brainstem and reduces sympathetic outflow Rebound hypertension Pregnancy category C Dry mouth Drowsiness Dizziness Sedation Constipation Koefelenberg CFN et al. J Am Med (2): Methods Randomized, blinded, placebo-controlled clinical trial with a 12-week treatment period and 12-week follow-up Four hundred forty-six generally healthy smokers were randomized (1:1); 435 were included in the efficacy and safety analyses Results Combination treatment was associated with a higher continuous abstinence rate at 12 weeks (55.4%vs 40.9%) and 24 weeks (49.0% vs32.6%) and point prevalence abstinence rate at 6 months (65.1%vs 46.7%) Clonidine (Catapres, Catapres-TTS ) Dosing Begin 3 days before quit date or on the quit date Tablet: mg daily Patch: mg per 24 hours (via appropriate strength patch applied once every 7 days) Counseling Points Applypatch to hairless location between the neck and waist Do not discontinue therapy abruptly Conclusion Vareniclinein combination with NRT was more effective than vareniclinealone at achieving tobacco abstinence at 12 weeks (end of treatment) and at 6 months Koefelenberg CFN et al. J Am Med (2):
17 Nortriptyline(Pamelor ) Efficacy of Nortriptyline (Pamelor ) Mechanism of Action Precautions Adverse Effects Blocks reuptake of norepinephrine and serotonin Risk of arrhythmias Use with caution in cardiovascular disease Avoid coadministration with MAOIs Pregnancy category D Sedation Dry mouth Blurred vision Urinary retention Lightheadedness Shaky hands Conflicting data exist regarding increased efficacy with combination therapy using nortriptyline and NRT compared to monotherapy 65 Ebbert et al. (2010). Drugs 2010; 70(6): Nortriptyline (Pamelor ) Combination Therapy Dosing Begin days before quit date Initially 25 mg daily, gradually increase to mg daily Counseling Points Do not discontinue abruptly because of withdrawal effects Combination of NRT Long-acting formulation (patch) + short-acting formulation (gum, inhaler, nasal spray) Bupropion SR + nicotine patch Bupropion SR + varenicline Varenicline + NRT
18 Combination Therapy Increased abstinence rates Enhanced relief of withdrawal effects Considered in highest risk of relapse Previously failed monotherapy Smokers with high nicotine-dependence Heavy smokers (i.e. 20 cigarettes or more per day) Additional cost must be considered Ebbert JO, Hays JT, Hurt RD. Combination pharmacotherapy for stopping smoking: what advantage does it offer? Drugs 2010; 70(6): Results At 12 weeks, 53% of the combination therapy group achieved prolonged and 56.2% achieved 7-day point-prevalence smoking abstinence, compared to 43.2% and 48.6% in varenicline monotherapy At 26 weeks, 36.6% of the combination therapy group achieved prolonged and 38.2% achieved 7-day point-prevalence smoking abstinence, compared to 27.6% and 31.9% in varenicline monotherapy At 52 weeks, 30.9% of the combination therapy group achieved prolonged and 36.6% achieved 7-day point-prevalence smoking abstinence, compared to 24.5% and 29.2% in varenicline monotherapy Participants receiving combination therapy reported more anxiety and depressive symptoms Conclusion Combined use of vareniclineand bupropion, compared with vareniclinealone, increased prolonged abstinence but not 7-day point prevalence at 12 and 26 weeks Neither outcome was significantly different at 52 weeks Ebbert JO et al. J Am Med (2): Title Combination Vareniclineand BuproprionSR for Tobacco Dependence Treatment in Cigarette Smokers: A Randomized Trial Outcomes Primary outcome was the prolonged (no smoking from 2 weeks after the target quit date) and 7-day point-prevalence (no smoking past 7 days), and abstinence rates at week 12 Secondary outcomes were prolonged and point-prevalence smoking abstinence rates at weeks 26 and 52 Methods Pharmacotherapy Use in Pregnancy Insufficient evidence for recommendations in pregnant smokers Category C: varenicline, bupropion SR Category D: nicotine replacement therapy Behavioral interventions are the preferred treatment Randomized, blinded, placebo-controlled multicenter clinical trial with a 12-week treatment period and 52-week follow-up Five hundred six cigarette smoking adults ( 18 years) were randomized and 315 (62%) completed the study Ebbert JO et al. J Am Med (2):
19 Pharmacotherapy: Other Special Populations Role of the Pharmacist Pharmacotherapy is NOT recommended for: Assist in the selection of OTC products Smokeless tobacco users Smoking fewer than 10 cigarettes per day Adolescents OTC sales are restricted to adults 18 years or older Nicotine replacement therapy use in minors require a prescription Counsel on proper use of smoking cessation medications Assist physicians with evidence based recommendations Monitor drug interactions with smoking and smoking cessation therapy 73 Saba M et al. J Clin Pharm and Ther. 2014;39: Role of the Pharmacist Questions Ask about tobacco use Advise patient to quit Explain the risks and complications of tobacco use Promote and encourage smoking cessation Referral to a formal cessation program Encourage and provide support Saba M et al. J Clin Pharm and Ther. 2014;39:
20 References : 2008 Update. Clinical Practice Guideline. Rockville, MD: USDHHS, PHS, May Stead LF et al. Nicotine replacement therapy for smoking cessation. Cochrane Review 2012, Issue 11 Ebbert JO, Hays JT, Hurt RD. Combination pharmacotherapy for stopping smoking: what advantage does it offer? Drugs 2010; 70(6): Bullen C et al. Electronic cigarettes for smoking cessation: a randomised controlled trial. Lancet Sep Economic Facts About U.S Tobacco Production and Use. Centers for Disease Control and Prevention. [Accessed January 25, 2016]. Available at: National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health: The Health Consequences of Smoking. A Report of the Surgeon General.Atlanta, GA, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, May 27, Available at: Accessed January25, References Silagy, C., et al., Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev, 2004(3): p. CD Croghan IT et al. (2007) Randomized comparison of a nicotine inhaler and bupropion for smoking cessation and relapse prevention. Mayo Clin Proc. 82(2): Piper ME et al (2009) Arch Gen Psych 66(11): Baker TB, Breslau N, Covey L, Shiffman S: DSM criteria for tobacco use disorder and tobacco withdrawal: a critique and proposed revisions for DSM-5. Addiction 107(2): , 2012 DiFranza, J.R.; Savageau, J.A.; Fletcher, K.; Ockene, J.K.; Rigotti, N.A.; McNeill, A.D.; Coleman, M.; Wood, C. (2002) Measuring the loss of autonomy over nicotine use in adolescents: Th e Development and Assessment of Nicotine Dependence in Youths (DANDY) Study. Archives of Pediatric Adolescent Medicine. 156: Heatherton, T.F.; Kozlowski, L.T.; Frecker, R.C.; Fagerström, K.O. (1991). Th e Fagerström Test for Nicotine Dependence: A Revision of the Fagerström Tolerance Questionnaire. British Journal of Addiction, 86 (9): Ebbert JO, Patten CA, Schroeder DR. Th e Fagerström Test for Nicotine Dependence- Smokeless Tobacco (FTND-ST). Addictive Behaviors 31(9), 2006, Saba M, Diep j, Saini B et al. Meta-analysis of the effectiveness of smoking cessation interventions in community pharmacy. J Clin Pharm and Ther. 2014;39:
Smoking cessation therapy
Appendix 1 Smoking cessation therapy Q. Can a dentist prescribe medications for smoking cessation? A. Yes. Dentists are allowed and are encouraged to help patients with smoking cessation by counseling
More informationIMPORTANT POINTS ABOUT MEDICATIONS
IMPORTANT POINTS ABOUT MEDICATIONS The U.S. Food & Drug Administration (FDA) advises that there are significant health benefits to quitting smoking. The health benefits of quitting smoking include a reduction
More informationMy Mask. I keep it all inside. Because I d rather. The pain destroy me. Than everyone else. Anon.
My Mask KL I keep it all inside Because I d rather The pain destroy me Than everyone else. Anon. 43 K. N. Roy Chengappa, M.D., FRCPC Professor of Psychiatry, University of Pittsburgh School of Medicine,
More informationMedication Management to Aid in Smoking Cessation. Rachel Constant, Pharm.D. Baptist Health Corbin Pharmacy Resident 3/22/2019
Medication Management to Aid in Smoking Cessation Rachel Constant, Pharm.D. Baptist Health Corbin Pharmacy Resident 3/22/2019 1 Learning Objectives: Review the prevalence of tobacco use. Describe tools
More information5. Offer pharmacotherapy to all smokers who are attempting to quit, unless contraindicated.
0 11 Key Messages 1. Ask and document smoking status for all patients. 2. Provide brief advice on quit smoking at every visit to all smokers. 3. Use individual, group and telephone counselling approaches,
More informationNYSMPEP Smoking Cessation Guidance: Key Message 3
NYSMPEP Smoking Cessation Guidance: Key Message 3 Key Message 3: All smokers trying to quit should be offered medication (except when contraindicated or for specific populations). The Agency for Healthcare
More informationCessation Medicine Reference Guide Table of Contents
Cessation Medicine Reference Guide Table of Contents 1. Patch 2. Nicotine Gum 3. Nicotine Lozenge 4. Inhaler 5. Nasal Spray 6. Bupropion SR (Zyban) 7. Chantix (Varenicline) Patch Typical course of therapy
More informationTREATMENT INTERVENTIONS
SMOKING CESSATION TREATMENT INTERVENTIONS Smoking and Health Tobacco is the single most preventable cause of death in the world today. kills more than five million people By 2030, the death toll will exceed
More informationPharmacotherapy for Treating Tobacco Dependence
Pharmacotherapy for Treating Tobacco Dependence Sheila K. Stevens, MSW Education Coordinator Nicotine Dependence Center 2013 MFMER slide-1 Rationale for Pharmacological Therapy Success rate doubles Manage
More informationAIDS for CESSATION PHARMACOTHERAPY. METHODS for QUITTING. NONPHARMACOLOGIC METHODS (cont d) NONPHARMACOLOGIC METHODS
METHODS for QUITTING AIDS for CESSATION Nonpharmacologic Counseling and other non-drug approaches Pharmacologic FDA-approved medications Counseling and medications are both effective, but the combination
More informationAIDS for CESSATION PHARMACOTHERAPY. METHODS for QUITTING. NONPHARMACOLOGIC METHODS (cont d) NONPHARMACOLOGIC METHODS
METHODS for QUITTING AIDS for CESSATION Nonpharmacologic Counseling and other non-drug approaches Pharmacologic FDA-approved medications Counseling and medications are both effective, but the combination
More informationPharmacotherapy Summary for the Treatment of Nicotine Withdrawal and Nicotine Dependence 1
Pharmacotherapy Summary for the Treatment of Nicotine Withdrawal and Nicotine Dependence 1 Compiled by: TOP, in collaboration with Dr. Charl Els and Mr. Ron Pohar: TRaC II (Alberta Medical Association/Primary
More informationSmoking Cessation: Treating Tobacco Dependence
Smoking Cessation: Treating Tobacco Dependence Pat Folan, RN Center for Tobacco Control Pulmonary Medicine NS-LIJ Health System NYS DOH Tobacco Control Program Treating Tobacco Dependence Center for Tobacco
More informationTobacco Cessation The Role of the Dentist/Oral Medicinist
Tobacco Cessation The Role of the Dentist/Oral Medicinist Jennifer Frustino, DDS PhD Oral Oncology & Maxillofacial Prosthetics Erie County Medical Center Buffalo, NY Statement of Disclosure I have no actual
More informationTobacco Dependence Screening and Treatment in Behavioral Health Settings. Prescribing
Tobacco Dependence Screening and Treatment in Behavioral Health Settings Prescribing GOAL To build the capacity of prescribing clinicians in behavioral health settings to integrate best practices for prescribing
More informationPharmacologic Therapy for Tobacco Use & Dependence
Pharmacologic Therapy for Tobacco Use & Dependence Thomas Gauvin, MA, TTS Mayo Clinic Nicotine Dependence Center Rochester, MN 2013 MFMER slide-1 Learning Objectives Understand the 7 first line medications
More informationChantix (Varenicline) and Risk of Cardiovascular Events
PL Detail-Document #270803 This PL Detail-Document gives subscribers additional insight related to the Recommendations published in PHARMACIST S LETTER / PRESCRIBER S LETTER August 2011 Chantix (Varenicline)
More informationBackground. Abstinence rates associated with varenicline
What are the range of abstinence rates for varenicline for smoking cessation? Do they differ based on treatment duration? Are there any studies utilizing 3-4 months of varenicline treatment? Background
More informationSmoke-free Hospitals. Linda A. Thomas, MS University of Michigan Health System Tobacco Consultation Service
Smoke-free Hospitals Linda A. Thomas, MS University of Michigan Health System Tobacco Consultation Service Today s Subjects 5A s and Clinician Training and Use with the Hospitalized Patient NRT use in
More informationNicotine Replacement Therapy (NRT).
Nicotine Replacement Therapy (NRT). Information for smokers 1 What is NRT? The aim of Nicotine Replacement Therapy (NRT) is to reduce the withdrawal symptoms associated with nicotine addiction by replacing
More informationSmoking Cessation Services Guidance
Smoking Cessation Services Guidance Alabama Medicaid Tobacco Treatment Coverage Covered Services/Medication 1. Free tobacco cessation counseling is provided through the Alabama Tobacco Quitline. Refer
More informationPHARMACOTHERAPY OF SMOKING CESSATION
PHARMACOTHERAPY OF SMOKING CESSATION Domenic A. Ciraulo, MD Director of Alcohol Pharmacotherapy Research Center for Addiction Medicine Department of Psychiatry Massachusetts General Hospital Disclosure
More informationSMOKING CESSATION. Recommendations 5As Approach to Smoking Cessation. Stages of Change Assisting the Smoker. Contributor Dr. Saifuz Sulami.
SMOKING CESSATION 08 Recommendations 5As Approach to Intervention Stages of Change Assisting the Smoker Pharmacotherapy Contributor Dr. Saifuz Sulami Advisor Dr. Audrey Tan 79 nhg_guideline_14102010_1112.indd
More informationHIV and Aging. Making Tobacco Cessation a Priority in HIV/AIDS Services. Objectives. Tobacco Use Among PLWHA
HIV and Aging Making Tobacco Cessation a Priority in HIV/AIDS Services June 27, 2008 Amanda Brown, MPH Ruth Tripp, MPH, RN Objectives To explore existing knowledge of the HIV and smoking connection. To
More informationSmoking Cessation and the Pharmacist
Smoking Cessation and the Pharmacist Jennifer Roberts Assistant Director, Research Pharmacy 1 Objectives Review smoking cessation medication use, based on public health guidelines, as well as contraindications
More informationNicotine Replacement Therapy, Zyban and Champix. Name of presentation
Nicotine Replacement Therapy, Zyban and Champix Nicotine Replacement Therapy (NRT) - Rationale for use Nicotine is highly addictive and causes unpleasant withdrawal symptoms which often undermine a quit
More informationClearing the Air: What You Need to Know and Do to Prepare to Quit Smoking
Clearing the Air: What You Need to Know and Do to Prepare to Quit Smoking Getting Ready to Quit Course Creating Success! THINK ABOUT Process of Changing an Addiction Your Pros and Cons of Smoking and Quitting
More informationNicotine Replacement and Smoking Cessation: Update on Best Practices
Nicotine Replacement and Smoking Cessation: Update on Best Practices Adrienne Duckworth, MSN, APRN, FNP-C, CTTS Section of Hematology/Oncology WVU Department of Medicine WVU Cancer Institute Objective
More informationEffective Treatments for Tobacco Dependence
Effective Treatments for Tobacco Dependence Abigail Halperin MD, MPH Director, University of Washington Tobacco Studies Program Ken Wassum Associate Director of Clinical Development and Support Quit for
More informationHelping People Quit Tobacco
Helping People Quit Tobacco Peter Selby MBBS, CCFP, MHSc, ASAM Associate Professor, University of Toronto Clinical Director, Addictions Program, CAMH Principal Investigator, OTRU Disclosures! Grants/research
More informationTOBACCO CESSATION: INCORPORATING MOTIVATIONAL INTERVIEWING AND EXAMINING THE ROLE OF E-CIGS
Learning Objectives TOBACCO CESSATION: INCORPORATING MOTIVATIONAL INTERVIEWING AND EXAMINING THE ROLE OF E-CIGS Cheyenne Newsome, PharmD PGY2 Ambulatory Care Resident University of New Mexico College of
More informationAddressing Tobacco Use in Iowa
Addressing Tobacco Use in Iowa A BRIEF TOBACCO INTERVENTION FOR HEALTHCARE PROVIDERS Lorene Mein Beth Turner Alyssa Reichelt DNP, ARNP, FNP-BC MA, CHES MA Mercy Clinics American Lung Association American
More informationBest Practice for Smoking Cessation: Pharmacotherapy. Emma Dean Acting Population Health and Health Promotion Coordinator Lead Pharmacist- Smokefree
Best Practice for Smoking Cessation: Pharmacotherapy Emma Dean Acting Population Health and Health Promotion Coordinator Lead Pharmacist- Smokefree Why is it so hard to quit? People who smoke aren t weak
More informationTOBACCO CESSATION: INCORPORATING MOTIVATIONAL INTERVIEWING AND EXAMINING THE ROLE OF E-CIGS
TOBACCO CESSATION: INCORPORATING MOTIVATIONAL INTERVIEWING AND EXAMINING THE ROLE OF E-CIGS Cheyenne Newsome, PharmD PGY2 Ambulatory Care Resident University of New Mexico College of Pharmacy Learning
More information1. Describe the benefits of smoking cessation. 2. List the withdrawal symptoms of quitting smoking. Cessation
Time to Butt Out Adil Virani, BSc (Pharm), Pharm D, FCSHP Objectives After this presentation, participants should be able to: 1. Describe the benefits of smoking cessation 2. List the withdrawal symptoms
More informationClinical Guideline / Formulary Document Pharmacy Department Medicines Management Services
Clinical Guideline / Formulary Document Pharmacy Department Medicines Management Services SMOKING CESSATION Introduction NICE recommends that Nicotine Replacement Therapy (NRT), bupropion [Zyban ] and
More informationWelcome Please stand by. We will begin shortly.
Welcome Please stand by. We will begin shortly. Integrating Medications into Smoking Cessation Treatment: The Basics Tuesday, September 22, 2015 2pm ET (90 minutes) Disclosure Dr. Robin L. Corelli, Dr.
More informationOutpatient Tobacco Addiction Treatment Pathway Additional Notes
Outpatient Tobacco Addiction Treatment Pathway Additional Notes First Line: Varenicline (provide in conjunction with counselling/support, but if such support is refused or is not available, this should
More informationSMOKING CESSATION WORKSHOP. Dr Mark Palayew December
SMOKING CESSATION WORKSHOP Dr Mark Palayew December 5 2016 Conflicts of Interest None Case 1 Mr. T is a 55 year old smoker 2 packs/day He has been smoking continuously since age 16 When he wakes up at
More informationMEDICATION COVERAGE POLICY PHARMACY AND THERAPEUTICS ADVISORY COMMITTEE
MEDICATION COVERAGE POLICY PHARMACY AND THERAPEUTICS ADVISORY COMMITTEE POLICY: Smoking Cessation Products LAST REVIEW 5/8/2018 THERAPEUTIC CLASS: Psychiatric Disorders REVIEW HISTORY 5/17, 5/16, 5/15,
More informationKicking the Habit Pharmacological Help for Smokers
Kicking the Habit Pharmacological Help for Smokers Catherine E. Cooke, PharmD, BCPS, PAHM Independent Consultant Clinical Assistant Professor, Univ. of Maryland Special Thanks to Teisha Robertson, PharmD
More informationWANTED. Pharmacists to Help Patients Quit Smoking: Best practices and updates in cessation treatment. Robin Corelli, PharmD
WANTED Pharmacists to Help Patients Quit Smoking: Best practices and updates in cessation treatment Robin Corelli, PharmD UCSF School of Pharmacy Karen Hudmon, DrPH, MS, RPh Purdue University College of
More informationKAREN MYERS, ARNP Certified Tobacco Training Specialist
KAREN MYERS, ARNP Certified Tobacco Training Specialist At the conclusion of this talk the learner will be able to: discuss the absorption of nicotine and how it is affected Discuss the addictive properties
More informationTobacco Cessation: Priority for Health Providers. Acknowledgements. Tobacco Cessation: Secondhand Smoke. Smoke-Free Environment & CA
Acknowledgements Smoking Cessation Leadership Center http://smokingcessationleadership.ucsf.edu/ Rx for Change http://rxforchange.ucsf.edu/ Tobacco Use and Dependence: 2008 Update http://www.surgeongeneral.gov/tobacco
More informationTB and Tobacco: Pharmacotherapy for Tobacco. Cessation. Cathy Cook, LCSW, CTTS
TB and Tobacco: Pharmacotherapy for Tobacco Cessation Cathy Cook, LCSW, CTTS Objectives 1. Describe the pharmacokinetics of nicotine to aid providers in treating TB patients who use tobacco. 2. List the
More informationSmoking Cessation Strategies: What Works?
Smoking Cessation Strategies: What Works? Andrew M. Busch, Ph.D. Centers For Behavioral and Preventive Medicine The Miriam Hospital Department of Psychiatry and Human Behavior Alpert Medical School of
More informationSmoking Cessation: Where Are We Now? Nancy Rigotti, MD
Smoking Cessation: Where Are We Now? Nancy Rigotti, MD Director, MGH Tobacco Research and Treatment Center Professor of Medicine, Harvard Medical School nrigotti@partners.org OVERVIEW The challenge for
More informationDispensing of Nicotine Replacement Therapy (NRT)
Simcoe Muskoka District Health Unit Print Version Medical Directive Number: Topic: Dispensing of Nicotine Replacement Therapy (NRT) Revised: October 2011 Approved: May 21, 2007 Description Nicotine Replacement
More informationPharmacologic Therapy for Tobacco Use & Dependence Nicotine Replacement Therapy (NRT) and Bupropion
Pharmacologic Therapy for Tobacco Use & Dependence Nicotine Replacement Therapy (NRT) and Bupropion Jennifer Bluem Moran, MA, TTS Mayo Clinic Nicotine Dependence Center Rochester, MN 2013 MFMER slide-1
More information3. Chantix [package insert]. New York, NY: Pfizer, Inc,; Ramon JM, Morchon S, Baena A, Masuet-Aumatell C. Combining varenicline and nicotine
How can there be a warning regarding concomitant use of varenicline with nicotine replacement therapy yet patients can be on varenicline and smoke concurrently? April 20, 2017 The United States (US) Preventive
More informationNonprescription Nicotine Replacement Therapy
Nonprescription Nicotine Replacement Therapy (a one-hour continuing education program) This program covers the nicotine patch, lozenge, and gum, including patient education information and a brief overview
More informationEVIDENCE-BASED INTERVENTIONS TO HELP PATIENTS QUIT TOBACCO
EVIDENCE-BASED INTERVENTIONS TO HELP PATIENTS QUIT TOBACCO Lena Matthias Gray, MSA, CTTS-M University of Michigan MHealthy Tobacco Consultation Service Overview of Tobacco Use The World Health Organization
More informationCessation of Smoking By Nicotine Replacement Therapy
Review Article ISSN: 0974-6943 Mamatha. J et al / Journal of Pharmacy Research 2017,11(5), Available online through http://jprsolutions.info Cessation of Smoking By Nicotine Replacement Therapy Mamatha.
More informationChronic Obstructive Pulmonary Disease 1 4/11/20128:52:12 AM
Chronic Obstructive Pulmonary Disease 1 4/11/20128:52:12 AM Table of Contents The Four Stages of COPD. 3 Modified Medical Research Council Dyspnea Scale. 3 Spirometry. 4 Alpha 1 Antitrypsin Deficiency...
More informationTime to Butt Out. Adil Virani, BSc (Pharm), Pharm D, FCSHP
Time to Butt Out Adil Virani, BSc (Pharm), Pharm D, FCSHP Objectives After this presentation, participants should be able to: 1. Describe the benefits of smoking cessation 2. List the withdrawal symptoms
More informationHIV & TOBACCO USE PHARMACOLOGIC AND BEHAVIORAL METHODS TO HELP YOUR PATIENTS QUIT
MARCH 2014 HIV & TOBACCO USE PHARMACOLOGIC AND BEHAVIORAL METHODS TO HELP YOUR PATIENTS QUIT HIV PROVIDER REFERENCE SERIES A PUBLICATION OF THE MOUNTAIN PLAINS AIDS EDUCATION AND TRAINING CENTER MountainPlains
More informationSmoking and Nicotine Replacement Therapy (NRT) Lec:5
Smoking and Nicotine Replacement Therapy (NRT) Lec:5 Tobacco use remains the single largest preventable cause of mortality. Cigarette smoke is a complex mixture of an estimated 4800 compounds. Approximately
More informationTREATMENT OF NICOTINE DEPENDENCE
TREATMENT OF NICOTINE DEPENDENCE Introduction Most commonly used substance the world over. Largest cause of preventable death worldwide. Leading causes of smoking related death Cardiovascular diseases
More informationSTEP Four: ASSIST with Quitting. STEP One: ASK about Tobacco Use TOBACCO CESSATION COUNSELING GUIDESHEET. STEP Two: Strongly ADVISE to Quit
STEP One: ASK about Tobacco Use Suggested Dialogue Do you ever smoke or use any type of tobacco? I take time to talk with all of my patients about tobacco use because it s important. Medication X often
More informationSMART STEPS towards a tobacco-free life
SMART STEPS towards a tobacco-free life Ready to Quit Smoking? You decide when. We ll show you how. Smart steps... Ready to Put Tobacco Behind You? Congratulations on deciding to quit! Quitting tobacco
More informationHow to help your patient quit smoking. Christopher M. Johnson MD, PhD
How to help your patient quit smoking Christopher M. Johnson MD, PhD Outline Smoking and its effects on IBD CD UC Clinical interventions Pharmacotherapy Resources Outline Smoking and its effects on IBD
More informationDERBYSHIRE JOINT AREA PRESCRIBING COMMITTEE (JAPC)
DERBYSHIRE JOINT AREA PRESCRIBING COMMITTEE (JAPC) Derbyshire Formulary for Nicotine Replacement Therapy (NRT) 1. Supporting Smokers to stop smoking The most effective method to quit smoking is by quitting
More informationPharmacotherapy for Smoking Cessation
Pharmacotherapy for Smoking Cessation (a one-hour continuing education program) This program provides an overview of all FDA-approved medications for cessation (nicotine patch, lozenge, gum, inhaler, nasal
More informationSee Important Reminder at the end of this policy for important regulatory and legal information.
Clinical Policy: Reference Number: CP.CPA.113 Effective Date: 11.16.16 Last Review Date: 11.17 Line of Business: Commercial Revision Log See Important Reminder at the end of this policy for important regulatory
More information4/2/2015. Inpatient Smoking Cessation. Smoking Cessation Documentation Patient's Stage of Behavior Change
Implementing Updates Barbara Darsow COTA/BA, CES TEAM Project: Promoting in Hospital Patients 1996 Smoke Free 2000 Coalition Completed Training Smoking cessation counselor at Mayo Clinic Tobacco research
More informationTobacco Use Dependence and Approaches to Treatment
University of Kentucky UKnowledge Nursing Presentations College of Nursing 11-2011 Tobacco Use Dependence and Approaches to Treatment Audrey Darville University of Kentucky, audrey.darville@uky.edu Chizimuzo
More informationWHAT IS THE GUIDELINE
WHAT IS THE GUIDELINE WHAT IS THE GUIDELINE Treating Tobacco Use and Dependence, a Public Health Service Clinical Practice Guideline, is the result of an extraordinary partnership among Federal Government
More informationTobacco Cessation For Providers. Betty Murphy Health Promotion Program Naval Hospital Rota
Tobacco Cessation For Providers Betty Murphy Health Promotion Program Naval Hospital Rota Tobacco Statistics Strategies for Implementation Stages of Change Pharmacotherapy Tobacco Use Statistics 70% of
More informationBrief Intervention for Smoking Cessation. National Training Programme
Brief Intervention for Smoking Cessation National Training Programme Introduction Monitor tobacco use and prevention policies Protect people from tobacco smoke Offer help to quit tobacco use Warn about
More informationSTEP Four: ASSIST with Quitting. STEP One: ASK about Tobacco Use. STEP Two: ADVISE to Quit
STEP One: ASK about Tobacco Use Suggested Dialogue Do you ever smoke or use any type of tobacco? I take time to talk with all of my patients about tobacco use because it s important. Condition X often
More informationSee Important Reminder at the end of this policy for important regulatory and legal information.
Policy: Smoking Cessation Products Reference Number: TCHP.PHAR.18002 Effective Date: 01.01.19 Last Review Date: 10.12.18 Line of Business: Oregon Health Plan Revision Log See Important Reminder at the
More informationTobacco use assessment, brief counseling,, and quit line referral
Tobacco use assessment, brief counseling,, and quit line referral What is the evidence for tobacco cessation counseling? Tobacco use is the leading cause of preventable death in the US 1 Counseling and
More information7 DAY QUIT SMOKING CHALLENGE 7 DAY QUIT SMOKING CHALLENGE 7 DAY QUIT SMOKING PDF YOU CAN QUIT SMOKING. QUIT SMOKING CDC 1 / 5
7 DAY QUIT SMOKING PDF YOU CAN QUIT SMOKING. QUIT SMOKING CDC 1 / 5 2 / 5 3 / 5 7 day quit smoking pdf 7 Your guide to quitting smoking This guide is for smokers who want to quit and stay quit. Just like
More informationAl Heuer, PhD, RRT, RPFT Professor & Program Dir. Rutgers School of Health Related Professions
Al Heuer, PhD, RRT, RPFT Professor & Program Dir. Rutgers School of Health Related Professions Learning Objectives Review the Epidemiology and statistics regarding tobacco dependence Identify new tobacco
More informationTobacco Use & Dependence. Dr. Mohammad Taraz Clinical Pharmacist July 2012
Tobacco Use & Dependence Dr. Mohammad Taraz Clinical Pharmacist July 2012 Introduction As a major risk factor for a wide range of diseases, including cardiovascular conditions, cancers, & pulmonary disorders,
More informationUnitedHealthcare Pharmacy Clinical Pharmacy Programs
UnitedHealthcare Pharmacy Clinical Pharmacy Programs Program Number 2017 P 2045-6 Program Prior Authorization/HCR- Tobacco Cessation - Health Care Reform Medication Bupropion SR (generic Zyban), Chantix
More informationCounseling Patients about Smoking Cessation in the New Era of Cigarette Alternatives
Counseling Patients about Smoking Cessation in the New Era of Cigarette Alternatives This educational activity is sponsored by Postgraduate Healthcare Education, LLC and supported by an educational grant
More informationDisclaimers. Smoking and Smoking Cessation. Worldwide. Objectives. Statistics at Home. Smoking Epidemic 16/10/2017
Disclaimers Smoking and Smoking Cessation Dr. Janneke Gradstein CCFP(EM) Yarmouth, NS Received CHA Funding 6 th Annual Ottawa Conference: State of the Art Clinical Approaches to smoking cessation. References
More informationSTEP Four: ASSIST with Quitting. STEP One: ASK about Tobacco Use. STEP Two: Strongly ADVISE to Quit. STEP Three: ASSESS Readiness to Quit
STEP One: ASK about Tobacco Use Suggested Dialogue Do you, or does anyone in your household, ever smoke or use any type of tobacco? We ask all of our patients about tobacco use, because it can negatively
More informationSMOKING CESSATION IS HARD
POWER TO BREAK THE HOLD OF NICOTINE ADDICTION 1 SMOKING CESSATION IS HARD Most smokers try to quit 5-7 times before they are successful. 2 Why is it so hard to quit? Typical withdrawal symptoms from stopping
More informationSave a Life in 3 Minutes
Save a Life in 3 Minutes Tobacco Cessation for Dental Hygiene Care Produced by Margaret J. Fehrenbach, RDH, MS 1 Not since the polio vaccine has this nation had a better opportunity to make a significant
More informationSt. Joseph s Health PROVIDER BRIEF. Tobacco Dependence Treatment Guidelines Perinatal and Postpartum Women
St. Joseph s Health PROVIDER BRIEF Tobacco Dependence Treatment Guidelines Perinatal and Postpartum Women Quitting smoking is perhaps the most important action a pregnant woman can do to ensure the health
More informationASHP Therapeutic Position Statement on the Cessation of Tobacco Use
580 ASHP Therapeutic Position Statements ASHP Therapeutic Position Statement on the Cessation of Tobacco Use Position The American Society of Health-System Pharmacists (ASHP) discourages all use of tobacco
More informationWelcome Please stand by. We will begin shortly.
Welcome Please stand by. We will begin shortly. Beyond the Basics: Pharmacotherapy for Smoking Cessation Monday, March 14, 2016 1pm ET (120 minutes) Disclosure Dr. Robin L. Corelli, Dr. Karen S. Hudmon,
More informationTobacco use and dependence: an updated review of treatments
Activity CME Home Page Why should I treat tobacco dependence? How do I treat tobacco users? Ask Advise Assess Assist Arrange Motivational Interviewing Strategies Enhancing Motivation to Quit Tobacco The
More informationCIGARETTE SMOKING. Rx for CHANGE TRAINING OVERVIEW. EPIDEMIOLOGY of TOBACCO USE. TRENDS in ADULT SMOKING, by SEX U.S.,
Rx for CHANGE Tobacco Cessation in Respiratory Care TRAINING OVERVIEW Epidemiology of Tobacco Use Impact of Tobacco Use on Respiratory Health Nicotine Pharmacology & Addiction Assisting Patients with Quitting
More informationKicking Butts in the Twenty-First Century:
Kicking Butts in the Twenty-First Century: What Modern Science Has Learned about Smoking Cessation Prepared for THE AMERICAN COUNCIL ON SCIENCE AND HEALTH by Ashlee Dunston Assistant Director of Public
More informationUnitedHealthcare Pharmacy Clinical Pharmacy Programs
UnitedHealthcare Pharmacy Clinical Pharmacy Programs Program Number 2018 P 4005-2 Program Health Care Reform Tobacco Cessation Supply Limit (Therapy Duration) Override Kentucky Fully Insured Medication
More informationAfter the Last Cigarette
After the Last Cigarette Treatment Options for Quitting Tobacco By Susan Kahler, MBA, CTTS Risks from Smoking The Highly Engineered Product Nicotine Delivered by Inhalation Characteristics of Nicotine
More informationLearning Objectives 4/3/2018 UP IN SMOKE: NAVIGATING THE CHANGING LANDSCAPE OF SMOKING CESSATION BACKGROUND
UP IN SMOKE: NAVIGATING THE CHANGING LANDSCAPE OF SMOKING CESSATION Richard Dang, PharmD, APh, BCACP Assistant Professor of Clinical Pharmacy, USC School of Pharmacy Rory Kim, PharmD, BCACP Assistant Professor
More informationSmoking Cessation Treatment for Adolescents
Review Article Smoking Cessation Treatment for Adolescents Julie P. Karpinski, PharmD, 1 Erin M. Timpe, PharmD, 2 and Lisa Lubsch, PharmD 2 1 Department of Pharmacy Practice, Concordia University Wisconsin,
More informationSECTION 17: NICOTINE REPLACEMENT. Formulary and Prescribing Guidelines
SECTION 17: NICOTINE REPLACEMENT Formulary and Prescribing Guidelines 17.1 Introduction These guidelines should be used in conjunction with EPUT No Smoking Policy (HRP20) for service users who are 12 years
More informationTobacco Cessation Best Practices: Pharmacotherapy
Tobacco Cessation Best Practices: Pharmacotherapy Please do the following Housekeeping Turn off or mute your computer speakers. Mute your phone by dialing *6* (dial *6* again to unmute yourself) Copy this
More informationPharmacotherapy for Tobacco Dependence Treatment
Pharmacotherapy for Tobacco Dependence Treatment Nancy Rigotti, MD Professor of Medicine, Harvard Medical School Director, Tobacco Research and Treatment Center, Massachusetts General Hospital nrigotti@partners.org
More informationUnitedHealthcare Pharmacy Clinical Pharmacy Programs
UnitedHealthcare Pharmacy Clinical Pharmacy Programs Program Number 2018 P 2045-9 Program Prior Authorization/HCR- Tobacco Cessation - Health Care Reform Medication Bupropion SR (generic Zyban), Chantix
More informationEffects of Smoking and Methods of Cessation By Chetan Kaher
Effects of Smoking and Methods of Cessation By Chetan Kaher Cigarette smoking is the leading cause of preventable death in the United States. It accounts or almost 500,000 deaths per year, or one in every
More informationUpdate on SMOKING CESSATION. Supporting the PHO Performance Programme. 38 BPJ Issue 33
Update on SMOKING CESSATION Supporting the PHO Performance Programme 38 BPJ Issue 33 Key concepts The rate of smoking among New Zealanders is slowly reducing, however more work needs to be done to further
More informationSmoking Cessation CHAPTER 1. Alexander V. Prokhorov, Kentya H. Ford, and Karen Suchanek Hudmon. Overview. Introduction. Smoking and lung cancer
CHAPTER 1 Smoking Cessation Alexander V. Prokhorov, Kentya H. Ford, and Karen Suchanek Hudmon Overview Tobacco use is a public health issue of enormous importance, and smoking is the primary risk factor
More informationSmoking Cessation for Persons with Serious Mental Illness
Smoking Cessation for Persons with Serious Mental Illness MDQuit Best Practices Conference January 22, 2009 Faith Dickerson, Ph.D., M.P.H. Sheppard Pratt Health System Lisa Dixon, M.D., M.P.H. Melanie
More information