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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/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.
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide164.html
October 01, 2014 - Treatment Recommendations: Intensive Treatment (continued)
Treating Tobacco Use and Dependence … Intensive counseling is especially effective. … There is a strong dose-response relation between counseling intensity and quitting success. … Individual, group, and telephone counseling are effective tobacco use treatment formats.
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide113.html
October 01, 2014 - Treatment Recommendations: Counseling (Continued)
Treating Tobacco Use and Dependence: 2008 Update … Meta-analysis (2008): Effectiveness of and estimated abstinence rates for the combination of counseling … Medication alone
8
1.0
21.7
Medication and counseling
39
1.4 (1.2, 1.6)
27.6 (25.0,
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-overview/slide17.html
October 01, 2014 - Pro-Active Quitlines
Treating Tobacco Use and Dependence: 2008 Update Overview
Text version … Effectiveness of and estimated abstinence rates for quitline counseling compared to minimal interventions … , self-help or no counseling (n = 9 studies). … Minimal or no counseling or self-help
11
1.0
8.5
Quitline counseling
11
1.6
(1.4,
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide101.html
October 01, 2014 - Treatment Recommendations: Counseling (Continued)
Treating Tobacco Use and Dependence: 2008 Update … 55
1.9 (1.6, 2.2)
18.5 (15.8, 21.1)
a Formats included self-help, proactive telephone counseling … , group, or individual counseling.
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide49.html
October 01, 2014 - 2000 Recommendations Changed for 2008 (Continued)
Treating Tobacco Use and Dependence: 2008 Update … Children and Adolescents:
2000 Guideline: Recommendation: Counseling and behavioral interventions … (Strength of Evidence = C).
2008 Guideline Update: Recommendation #1: Counseling has been shown to … Therefore, adolescent smokers should be provided with counseling interventions to aid them in quitting
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www.ahrq.gov/prevention/guidelines/guide/section2d.html
June 01, 2014 - Tobacco Use in Adults
Title
Counseling and Interventions to Prevent Tobacco Use and Tobacco-Caused … use. … Grade: A
Ask about tobacco use. … Grade: A
Counseling
The “5-A” framework provides a useful counseling strategy:
Ask about tobacco … use.
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide84.html
October 01, 2014 - Treatment Recommendations: Counseling (Continued)
Treating Tobacco Use and Dependence: 2008 Update
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide89.html
October 01, 2014 - Treatment Recommendations: Counseling (Continued)
Treating Tobacco Use and Dependence: 2008 Update … Therefore, if feasible, clinicians should strive to meet four or more times with individuals quitting tobacco … use.
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide21.html
October 01, 2014 - Topics Meta-Analyzed for the 2008 Guideline Update
Treating Tobacco Use and Dependence: 2008 … Combining counseling and medication
Medication alone.
Counseling alone. … Medication and counseling combined.
Medications
Placebo medication.
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www.uspreventiveservicestaskforce.org/uspstf/sites/default/files/file/supporting_documents/tobaccofinalrsbulletin.pdf
September 22, 2015 - Preventive Services Task Force Recommends That Clinicians Ask All Adults About Tobacco Use and Offer … Preventive Services Task Force Recommends That Clinicians
Ask All Adults About Tobacco Use and Offer … Behavioral interventions include in-person counseling sessions, telephone
counseling, and tailored self-help … For pregnant women, the Task Force recommends that clinicians ask about tobacco use, advise
patients … Americans by making evidence-based
recommendations about clinical preventive services such as screenings, counseling