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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide208.html
October 01, 2014 - 208. Specific Populations and Other Topics - Pregnant Smokers (Continued)
Treating Tobacco Use and Dependence: 2008 Update
Text version of slide presentation.
Clinical practice suggestions for assisting a pregnant patient in stopping smoking
Clinical practice
Rationale
Assess pregnant woma…
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-overview/slide04.html
October 01, 2014 - 4. 2008 PHS Clinical Practice Guideline: Treating Tobacco Use and Dependence Update
Treating Tobacco Use and Dependence: 2008 Update Overview
Text version of slide presentation.
History:
1996—Initial Guideline published; literature from 1975-1995; approximately 3,000 articles.
2000—Revised Guideline…
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-overview/slide05.html
October 01, 2014 - 5. 2008 PHS Clinical Practice Guideline: Treating Tobacco Use and Dependence Update (continued)
Treating Tobacco Use and Dependence: 2008 Update Overview
Text version of slide presentation.
Update process started 7-1-06.
Scope remains the treatment of tobacco use and dependence.
Update rather than a…
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-overview/slide03.html
October 01, 2014 - 3. 2008 PHS Clinical Practice Guideline Update: Treating Tobacco Use and Dependence (continued)
Treating Tobacco Use and Dependence: 2008 Update Overview
Text version of slide presentation.
Brief history and developmental process.
Previous Slide Contents Next Slide
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-overview/slide22.html
October 01, 2014 - 22. Relative Efficacy
Treating Tobacco Use and Dependence: 2008 Update Overview
Text version of slide presentation.
Medication
Number of arms
Estimated odds ratio (95% C.I.)
Nicotine Patch (reference group)
32
1.0
Varenicline (2 mg/day)
5
1.6
(1.3, 2.0)
Patch (long-…
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide91.html
October 01, 2014 - 91. Treatment Recommendations: Counseling (Continued)
Treating Tobacco Use and Dependence: 2008 Update
Text version of slide presentation.
Intensity of Clinical Interventions
Meta-analysis (2000): Effectiveness of and estimated abstinence rates for total amount of contact time (n = 35 studies)
T…
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide90.html
October 01, 2014 - 90. Treatment Recommendations: Counseling (Continued)
Treating Tobacco Use and Dependence: 2008 Update
Text version of slide presentation.
Intensity of Clinical Interventions
Meta-analysis (2000): Effectiveness of and estimated abstinence rates for various intensity levels of session length (n =' 43 stu…
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide89.html
October 01, 2014 - 89. Treatment Recommendations: Counseling (Continued)
Treating Tobacco Use and Dependence: 2008 Update
Text version of slide presentation.
Intensity of Clinical Interventions
Recommendation: Person-to-person treatment delivered for four or more sessions appears especially effective in increasing abstin…
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide92.html
October 01, 2014 - 92. Treatment Recommendations: Counseling (Continued)
Text version of slide presentation.
Intensity of Clinical Interventions
Meta-analysis (2000): Effectiveness of and estimated abstinence rates for number of person-to-person treatment sessions (n = 46 studies)
Number of sessions
Number of arms…
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide84.html
October 01, 2014 - 84. Treatment Recommendations: Counseling (Continued)
Treating Tobacco Use and Dependence: 2008 Update
Text version of slide presentation.
Variables associated with higher or lower abstinence rates
Variables associated with higher abstinence rates
Variable
Examples
High motivation
…
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide85.html
October 01, 2014 - 85. Treatment Recommendations: Counseling (Continued)
Treating Tobacco Use and Dependence: 2008 Update
Text version of slide presentation.
Treatment Recommendations: Counseling (Continued)
Advice To Quit Smoking
Recommendation: All physicians should strongly advise every patient who smokes to quit …
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide86.html
October 01, 2014 - 86. Treatment Recommendations: Counseling (Continued)
Treating Tobacco Use and Dependence: 2008 Update
Text version of slide presentation.
Meta-analysis (1996): Effectiveness of and estimated abstinence rates for advice to quit by a physician (n = 7 studies)
Advice
Number of arms
Estimated odd…
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide103.html
October 01, 2014 - 103. Treatment Recommendations: Counseling (Continued)
Treating Tobacco Use and Dependence: 2008 Update
Text version of slide presentation.
Quitlines
Effectiveness of and estimated abstinence rates for quitline counseling compared to minimal interventions, self-help or no counseling (n = 9 studies)
…
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide138.html
October 01, 2014 - 138. Treatment Recommendations: Medications-Nicotine Lozenge
Treating Tobacco Use and Dependence: 2008 Update
Text version of slide presentation.
Patient selection
Appropriate as a first-line medication for treating tobacco use
Precautions, warnings, contraindications and side effects (see F…
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide136.html
October 01, 2014 - 136. Treatment Recommendations: Medications-Nicotine Inhaler (Continue)
Treating Tobacco Use and Dependence: 2008 Update
Text version of slide presentation.
Clinical guidelines for prescribing medication for treating tobacco use and dependence (continued)
Availability
Prescription only
Pre…
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide137.html
October 01, 2014 - 137. Treatment Recommendations: Medications
Treating Tobacco Use and Dependence: 2008 Update
Text version of slide presentation.
Nicotine Lozenge
Recommendation: The nicotine lozenge is an effective smoking cessation treatment that patients should be encouraged to use. (Strength of Evidence = B).
P…
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide172.html
October 01, 2014 - 172. Systems Strategy 2. Provide education, resources, and feedback to promote provider intervention
Treating Tobacco Use and Dependence: 2008 Update
Text version of slide presentation.
Action
Strategies for implementation
Health care systems should ensure that clinicians have sufficient t…
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide171.html
October 01, 2014 - 171. Systems Strategy 1. Implement a tobacco-user identification system in every clinic
Treating Tobacco Use and Dependence: 2008 Update
Text version of slide presentation.
Action
Strategies for implementation
Implement an office-wide system that ensures that for EVERY patient at EVERY clini…
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide173.html
October 01, 2014 - 173. Systems Strategy 3. Dedicate staff to provide tobacco dependence treatment and assess the delivery of this treatment in staff performance evaluations
Treating Tobacco Use and Dependence: 2008 Update
Text version of slide presentation.
Action
Strategies for implementation
Clinical sites …
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide170.html
October 01, 2014 - 170. System Strategies
Treating Tobacco Use and Dependence: 2008 Update
Text version of slide presentation.
Implementing a tobacco-user identification system in every clinic ( Systems Strategy 1 ).
Providing adequate training, resources, and feedback to ensure that providers consistently deliver effec…