Summary for Clinicians: An ATS Clinical Practice Guideline for Initiating Pharmacologic Treatment in Tobacco-Dependent Adults
An evidence-based guideline for initiating pharmacologic treatment in adults with tobacco dependence was published in 2020. A multidisciplinary panel of experts completed a systematic review of the literature with resulting synthesis of data. The intention of the guideline is to select appropriate pharmacological agents to treat tobacco dependence in adults. This summary provides key takeaway points for practicing clinicians. The guideline has different implications for patients, clinicians, and policymakers. Clinicians should always consider unique individual clinical and social circumstances when applying these guideline recommendations to the care plan of patients to ensure appropriate care.
The guideline discusses seven key recommendations, categorized under the following four themes: pharmacological agent of choice, when to initiate pharmacological therapy, concern for comorbidities, and duration of pharmacological therapy.
Pulmonologists, critical care specialists, translational researchers, and clinicians
At the conclusion of this activity, learners should be able to:
- Apply in real time the preferred controller medication that is more efficacious in helping a patient quit smoking, specifically, varenicline.
- Effectively communicate the efficacy of varenicline treatment as compared to other medications and how its side effect profile is minimal overall.
- Recognize that treatment for tobacco dependence can be extended beyond 6 months and should continue for as long as a patient needs.
The American Thoracic Society is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Article Authorship Disclosures (as submitted to the ATS prior to article publication date)
Panagis Galiatsatos, M.D., M.H.S. (Johns Hopkins School of Medicine, Baltimore, MD, USA) reported no relevant financial relationships.
Jamie Garfield, M.D. (Temple University Hospital, Philadelphia, PA, USA) reported no relevant financial relationships.
Anne C. Melzer, M.D., M.S. (Minneapolis VA Health Care System, Minneapolis, MN, USA) reported no relevant financial relationships.
Frank T. Leone, M.D., M.S. (University of Pennsylvania, Philadelphia, PA, USA) reported no relevant financial relationships.
Harold J. Farber, M.D., M.S.P.H. (Texas Children’s Hospital, Houston, TX, USA) reported serving as Associate Medical Director for Texas Children's Health Plan, a large not-for-profit provider-sponsored Medicaid managed care program.
Joseph K. Ruminjo, M.D. (American Thoracic Society, New York, NY, USA) reported no relevant financial relationships.
Carey C. Thomson, M.D., M.P.H. (Mount Auburn Hospital, Cambridge, MA, USA) reported no relevant financial relationships.
Off-Label Usage Disclosure
Disclosures of AnnalsATS CME Planners
The Annals of the American Thoracic Society (AnnalsATS) original research, commentaries, reviews, and educational content of interest to clinicians and clinical investigators in pediatric and adult pulmonary and sleep medicine and medical critical care. The scope of the journal encompasses content that is applicable to clinical practice, the formative and continuing education of clinical specialists, and the advancement of public health.
The publication of articles that meet these goals by itself is only one step in a multi-step process for the translation of evidence-based improvements in are to clinical practice. Testing for CME credit is designed to function as a next step in the process. This is accomplished through a series of questions written by the author(s) to test that readers have the tools needed to translate recommendations for diagnostic and therapeutic clinical care into clinical practice. Members of the AnnalsATS editorial board review these questions and edit these questions for clarity, educational content, and the quality of the evidence supporting the response to the question.
AnnalsATS CME Planners
Alan M. Fein, M.D.
Podcast Editor, AnnalsATS
Dr. Fein reported that he has no financial relationships with ineligible companies.
Constantine Manthous, M.D.
Associate Editor, AnnalsATS
Dr. Manthous reported that he has no financial relationships with ineligible companies.
Gregory A. Schmidt, M.D.
Editorial Board, AnnalsATS
Dr. Schmidt reported payments for writing a textbook on critical care medicine (McGraw-Hill) and for writing contributions for UptoDate.
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