The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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Effective Smoking-Cessation Strategies in Primary Care Setting

일차 진료의를 위한 효과적인 금연 치료법

  • Chun, Eun Mi (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ewha Womans University School of Medicine)
  • 천은미 (이화여자대학교 의학전문대학원 호흡기내과학교실)
  • Published : 2014.09.01
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Abstract

Smoking leads to nicotine addiction and serious health problems and smoking cessation can reduce the risk of developing smoking-related diseases and premature death. Smoking is a chronic disease that requires repeated interventions, including counseling and pharmacotherapy. These are both effective for smoking cessation, but combined intervention is more effective than using either alone. Several first-line medications are effective and recommended for use, such as nicotine-replacement therapy (patch, gum, inhaler, lozenge, and nasal spray), bupropion SR, and varenicline. Special populations such as adolescent smokers, pregnant women, and smokers with mental illness can be treated with both counselling and medication. Physicians should recommend effective counselling and pharmacotherapy strategies to all smokers at every clinic visit. Insurance coverage for counselling and medications for quitting smoking are essential to reduce the smoking rate, especially in a primary care setting.

Keywords

References

  1. National Toxicology Program. Report on Carcinogens, 12th Edition. Research Triangle Park: U.S. Department of Health and Human Sciences, National Institute of Environmental Health Sciences, National Toxicology Program, 2011.
  2. U.S. Department of Health and Human Services. How tobacco smoke causes disease: the biology and behavioral basis for smoking-attributable disease: a report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2010.
  3. U.S. Department of Health and Human Services. The health consequences of smoking - 50 years of progress: a report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.
  4. Agaku IT, King BA, Dube SR; Centers for Disease Control and Prevention (CDC). Current cigarette smoking among adults-United States, 2005-2012. MMWR Morb Mortal Wkly Rep 2014;63:29-34.
  5. Centers for Disease Control and Prevention. Behavioral risk factor surveillance system prevalence and trends data, 2012. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2013.
  6. Korean Center for Disease Control and Prevention. National survey of smoking rates. Korean National Health and Nutrition Examination Survey, 2012.
  7. Jha P, Ramasundarahettige C, Landsman V, et al. 21st-century hazards of smoking and benefits of cessation in the United States. N Engl J Med 2013;368:341-350. https://doi.org/10.1056/NEJMsa1211128
  8. Rigotti NA. Integrating comprehensive tobacco treatment into the evolving US health care system: it's time to act: comment on "a randomized trial of internet and telephone treatment for smoking cessation". Arch Intern Med 2011;171:53-55.
  9. Shiffman S, Brockwell SE, Pillitteri JL, Gitchell JG. Use of smoking-cessation treatments in the United States. Am J Prev Med 2008;34:102-111. https://doi.org/10.1016/j.amepre.2007.09.033
  10. Fiore MC, Jaen CR, Baker TB, et al. Treating tobacco use and dependence: 2008 update-clinical practice guidelines. Rockville (MD): U.S. Department of Health and Human Services, Public Health Service, Agency for Healthcare Research and Quality, 2008.
  11. Richmond RL, Makinson RJ, Kehoe LA, Giugni AA, Webster IW. One-year evaluation of three smoking cessation interventions administered by general practitioners. Addict Behav 1993;18:187-199. https://doi.org/10.1016/0306-4603(93)90049-F
  12. Fiore MC, Bailey WC, Cohen SJ, et al. Treating tobacco use and dependence: clinical practice guideline. US Department of Health and Human Services, Public Health Service, Agency for Health Care policy and research. 2000.
  13. Papadakis S, McDonald P, Mullen KA, Reid R, Skulsky K, Pipe A. Strategies to increase the delivery of smoking cessation treatments in primary care settings: a systematic review and meta-analysis. Prev Med 2010;51:199-213. https://doi.org/10.1016/j.ypmed.2010.06.007
  14. Schnoll RA, Rukstalis M, Wileyto EP, Shields AE. Smoking cessation treatment by primary care physicians: an update and call for training. Am J Prev Med 2006;31:233-239. https://doi.org/10.1016/j.amepre.2006.05.001
  15. Mills EJ, Wu P, Lockhart I, Wilson K, Ebbert JO. Adverse events associated with nicotine replacement therapy (NRT) for smoking cessation: a systematic review and meta-analysis of one hundred and twenty studies involving 177,390 individuals. Tob Induc Dis 2010;8:8. https://doi.org/10.1186/1617-9625-8-8
  16. Jorenby DE, Hays JT, Rigotti NA, et al. Efficacy of varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs placebo or sustained-release bupropion for smoking cessation: a randomized controlled trial. JAMA 2006;296:56-63. https://doi.org/10.1001/jama.296.1.56
  17. Foulds J, Schmelzer AC, Steinberg MB. Treating tobacco dependence as a chronic illness and a key modifiable predictor of disease. Int J Clin Pract 2010;64:142-146.
  18. Stead LF, Bergson G, Lancaster T. Physician advice for smoking cessation. Cochrane Database Syst Rev 2008;(2):CD000165.
  19. Stead LF, Lancaster T. Group behavior therapy programmes for smoking cessation. Cochrane Database Syst Rev 2005;(2):CD001007.
  20. Bullen C, Howe C, Laugesen M, et al. Electronic cigarettes for smoking cessation: a randomised controlled trial. Lancet 2013;382:1629-1637. https://doi.org/10.1016/S0140-6736(13)61842-5
  21. Grana RA, Popova L, Ling PM. A longitudinal analysis of electronic cigarette use and smoking cessation. JAMA Intern Med 2014;174:812-813. https://doi.org/10.1001/jamainternmed.2014.187
  22. Glassman AH, Helzer JE, Covey LS, et al. Smoking, smoking cessation, and major depression. JAMA 1990;264:1546-1549. https://doi.org/10.1001/jama.1990.03450120058029
  23. Breslau N. Psychiatric comorbidity of smoking and nicotine dependence. Behav Genet 1995;25:95-101. https://doi.org/10.1007/BF02196920
  24. Banham L, Gilbody S. Smoking cessation in severe mental illness: what works? Addiction 2010;105:1176-1189. https://doi.org/10.1111/j.1360-0443.2010.02946.x
  25. Weiner E, Buchholz A, Coffay A, et al. Varenicline for smoking cessation in people with schizophrenia: a double blind randomized pilot study. Schizophr Res 2011;129:94-95. https://doi.org/10.1016/j.schres.2011.02.003