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Tobacco Use and Smoking Cessation

Felix B. Chang Cruz, MD, FAAMA, ABIHM and Roberto S. Amado, MD Reviewed 06/2020
 


BASICS

Use of tobacco of any form 

DESCRIPTION

  • The second leading actual cause of death in the United States

  • Smokeless tobacco refers to tobacco products that are vaporized, sniffed, sucked, or chewed.

  • Ni...

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

Both behavioral counseling and pharmacotherapy benefit patients who are trying to quit smoking especially when used in combination. 
ALERT

Report cases of lung injury of unclear etiology and a...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Follow up 3 to 7 days after scheduled quit date and at least monthly for 3 months thereafter.

  • Refraining from tobacco products for first 2 weeks is critical to lon...

REFERENCES

1
Cahill K, Stevens S, Perera R, et al. Pharmacological interventions for smoking cessation: an overview and network meta-analysis. Cochrane Database Syst Rev.  2013;(5):CD009329.
2
Stead...

ADDITIONAL READING

SEE ALSO

Nicotine Addiction; Substance Use Disorders 

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

  • Every patient who uses tobacco should be offered cessation advice.

  • Depression with suicidal ideations is no longer a contraindication to varenicline use; FDA

  • Refrain from using e-cigaret...

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