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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide194.html
October 01, 2014 - Specific Populations and Other Topics (Continued)
Treating Tobacco Use and Dependence: 2008 Update … vs. usual care or no counseling among individuals with low SES/limited formal education. … Meta-analytic results showed that counseling is effective in treating smokers with low SES/limited formal … education (OR = 1.42; 95% C.I. = 1.04-1.92) (Abstinence rate without counseling = 13.2 %; with counseling … for low-income mothers and low-income African Americans; proactive telephone counseling in addition
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide185.html
October 01, 2014 - Systems-Providing Treatment for Tobacco Use and Dependence as a Covered Benefit
Treating Tobacco … Use and Dependence: 2008 Update
Text version of slide presentation. … Recommendation:
Providing tobacco dependence treatments (both medication and counseling) as a paid
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide32.html
October 01, 2014 - Ten Key Guideline Recommendations (Continued)
Treating Tobacco Use and Dependence: 2008 Update … Counseling and medication are effective when used by themselves for treating tobacco dependence. … However, the combination of counseling and medication is more effective than either alone. … Thus, clinicians should encourage all individuals making a quit attempt to use both counseling and medication … Telephone quitline counseling is effective with diverse populations and has broad reach.
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/clinicians-providers/guidelines-recommendations/tobacco/clinicians/references/meta/meta-analyses-refs.pdf
January 01, 2007 - Treating Tobacco Use and Dependence, 2008 Update: References for Studies in Meta-analyses
1
References … Meta-analysis (1996): Impact of
having a tobacco use status identification
system in place on rates … Meta-analysis (1996): Impact of
having a tobacco use status identification
system in place on abstinence … Meta-analysis (1996): Impact of having a tobacco use status identification system in place on rates of … Meta-analysis (1996): Impact of having a tobacco use status identification system in place on abstinence
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-overview/slide13.html
October 01, 2014 - Combinations: Medication and Counseling
Treating Tobacco Use and Dependence: 2008 Update Overview … Effectiveness of and estimated abstinence rates for the combination of counseling and medication versus … Medication alone
8
1.0
21.7
Medication and counseling
39
1.4
(1.2, 1.6)
27.6
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-overview/slide10.html
October 01, 2014 - Final Selected Topics
Treating Tobacco Use and Dependence: 2008 Update Overview
Text version … Combining counseling and medication relative to either counseling or medication alone. … Tobacco use interventions for individuals with low socio-economic status/limited formal education. … Tobacco use interventions for adolescent smokers. … Tobacco use interventions for pregnant smokers.
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide106.html
October 01, 2014 - Treatment Recommendations: Counseling (Continued)
Treating Tobacco Use and Dependence: 2008 Update … Treatment Elements
Recommendation: Two types of counseling and behavioral therapies result in higher … abstinence rates: (1) providing smokers with practical counseling (problem-solving skills/skills training … These types of counseling elements should be included in smoking cessation interventions.
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide90.html
October 01, 2014 - Treatment Recommendations: Counseling (Continued)
Treating Tobacco Use and Dependence: 2008 Update … No contact
30
1.0
10.9
Minimal counseling (< 3 minutes)
19
1.3 (1.01, 1.6)
13.4 (10.9 … , 16.1)
Low intensity counseling (3-10 minutes)
16
1.6 (1.2, 2.0)
16.0 (12.8, 19.2) … Higher intensity counseling (> 10 minutes)
55
2.3 (2.0, 2.7)
22.1 (19.4, 24.7)
Previous
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide100.html
October 01, 2014 - Treatment Recommendations: Counseling (Continued)
Treating Tobacco Use and Dependence: 2008 Update … 20
1.0
10.8
Self-help
93
1.2 (1.02, 1.3)
12.3 (10.9, 13.6)
Proactive telephone counseling … 26
1.2 (1.1, 1.4)
13.1 (11.4, 14.8)
Group counseling
52
1.3 (1.1, 1.6)
13.9 (11.6, … 16.1)
Individual counseling
67
1.7 (1.4, 2.0)
16.8 (14.7, 19.1)
Previous Slide
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide46.html
October 01, 2014 - 2000 Recommendations Changed for 2008 (Continued)
Treating Tobacco Use and Dependence: 2008 Update … Types of Counseling and Behavioral Therapies:
2000 Guideline: Recommendation: Three types of counseling … and behavioral Therapies result in higher abstinence rates: (1) providing smokers with practical counseling … These types of counseling and behavioral therapies should be included in smoking cessation interventions … These types of counseling elements should be included in smoking cessation interventions.
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide167.html
October 01, 2014 - Components of Intensive Treatment (Continued)
Treating Tobacco Use and Dependence: 2008 Update … Program format
Either individual or group counseling may be used. … Telephone counseling also is effective and can supplement treatments provided in the clinical setting … Type of counseling and behavioral therapies
Counseling should include practical counseling (problem-solving
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide195.html
October 01, 2014 - Specific Populations and Other Topics (Continued)
Treating Tobacco Use and Dependence: 2008 Update … specific populations
Population of Smokers
Review of Evidence
Medical comorbidities
Tobacco … use treatments have been shown to be effective among smokers with a variety of comorbid medical conditions … Lung/COPD patients: intensive cessation counseling, intensive behavioral (relapse prevention) program … Cancer: counseling and medication; motivational counseling.
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide107.html
October 01, 2014 - Treatment Recommendations: Counseling (Continued)
Treating Tobacco Use and Dependence: 2008 Update … Meta-analysis (2000): Effectiveness of and estimated abstinence rates for various types of counseling … and behavioral therapies (n = 64 studies)
Type of counseling and behavioral therapy
Number … No counseling/ behavioral therapy
35
1.0
11.2
Relaxation/breathing
31
1.0 (0.7, 1.3) … 16.5)
Extra-treatment social support
19
1.5 (1.1, 2.1)
16.2 (11.8, 20.6)
Practical counseling
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-overview/slide48.html
October 01, 2014 - 48. 10 Key Guideline Recommendations (Numbers 4 and 5)
Treating Tobacco Use and Dependence: 2008 … Individual, group, and telephone counseling are effective, and their effectiveness increases with treatment … Two components of counseling are especially effective and clinicians should use these when counseling … patients making a quit attempt:
Practical counseling (problem solving/skills training).
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide30.html
October 01, 2014 - Ten Key Guideline Recommendations (Continued)
Treating Tobacco Use and Dependence: 2008 Update … Individual, group and telephone counseling are effective and their effectiveness increases with treatment … Two components of counseling are especially effective and clinicians should use these when counseling … patients making a quit attempt: Practical counseling (problem-solving/skills training) and social support
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide39.html
October 01, 2014 - -New Recommendations (Continued)
Treating Tobacco Use and Dependence: 2008 Update
Text version … Combining Counseling and Medication:
Recommendation: The combination of counseling and medication … is more effective for smoking cessation than either medication or counseling alone. … Therefore, whenever feasible and appropriate, both counseling and medication should be provided to patients … Therefore, to the extent possible, clinicians should provide multiple counseling sessions, in addition
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www.ahrq.gov/prevention/resources/chronic-care/clinical-community-relationships-eval-roadmap/ccre-roadmap-apb1.html
July 01, 2013 - Tobacco use counseling and interventions for non-pregnant adults. … Tobacco use counseling for pregnant women. … relationships for delivery of preventive services that address healthy diet, physical activity, obesity, or tobacco … use ( Porterfield et al., 2012 ). … screening, and counseling for children, and counseling for STIs.
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide204.html
October 01, 2014 - Specific Populations and Other Topics (Continued)
Treating Tobacco Use and Dependence: 2008 Update … Recommendation: Smokeless tobacco users should be identified, strongly urged to quit, and provided counseling … Evidence = A)
Recommendation: Clinicians delivering dental health services should provide brief counseling … noncigarette forms of smoking tobacco should be identified, strongly urged to quit, and offered the same counseling
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www.ahrq.gov/sites/default/files/wysiwyg/evidencenow/results/research/smoking-cessation-flowchart.pdf
August 24, 2018 - Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Preventive Care and … Screening: Tobacco Use:
Screening and Cessation
Intervention
Was the patient aged 18 years or … No
Yes
PATIENT
INCLUDED IN
DENOMINATOR
Was the patient
screened for tobacco
use during the … INCLUDED
IN NUMERATOR
PATIENT NOT
INCLUDED IN
DENOMINATOR
Was a tobacco cessation
intervention (counseling
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide23.html
October 01, 2014 - Topics Meta-Analyzed for the 1996 and 2000 Guidelines and Included
Treating Tobacco Use and Dependence … Characteristics analyzed
Categories of those characteristics
Screen for tobacco use
No … Minimal counseling (longest session ≤ 3 min in duration). … Low intensity counseling (longest session > 3 min and ≤ 10 min in duration). … Higher intensity counseling (longest session > 10 min).
Total amount of contact time.