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Tobacco Use and Smoking Cessation

Felix B. Chang, ABIM , ABIHM, FAAMA, MD. Reviewed 06/2022
 


BASICS

Use of tobacco of any form 

DESCRIPTION

  • Nicotine sources: cigars, pipes, water pipes, hookahs, cigarettes, and electronic cigarettes (e-cigarettes)

  • Electronic nicotine delivery system (ENDS) use i...

DIAGNOSIS

HISTORY

  • Ask about tobacco use and secondhand smoke exposure at every physician encounter.

  • Type and quantity of tobacco used: “Heavy smoking” is 20 or more cigarettes per day or 20 or more pack...

TREATMENT

ALERT

Report cases of lung injury of unclear etiology and a history of e-cigarette or vaping product use within the past 90 days to state or local health department.

 

GENERAL MEASURES

  • Behaviora...

ONGOING CARE

35-40% of patients relapse between years 1 and 5 after quitting. 2/3 of smokers who relapse report wanting to quit again within 30 days. 

FOLLOW-UP RECOMMENDATIONS

Follow up 3 to 7 days aft...

REFERENCES

1
The U.S. Preventive Services Task Force. Tobacco Smoking Cessation in Adults, Including Pregant Persons: Interventions. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/...

ADDITIONAL READING

U.S. Department of Health and Human Services. Smoking Cessation: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Centers ...

CODES

ICD10

  • F17.210 Nicotine dependence, cigarettes, uncomplicated

  • F17.213 Nicotine dependence, cigarettes, with withdrawal

  • F17.211 Nicotine dependence, cigarettes, in remission

  • Z71.6 Tobacco abuse counse...

CLINICAL PEARLS

  • Addressing tobacco cessation regularly improves patient satisfaction.

  • Nicotine replacement improves cessation rates.

  • Establish a quit date and provide resources to promote success (1-800...

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