Materiały źródłowe

• #1 Nicotine dependence | CAMH

  https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/nicotine-dependence

  Nicotine dependence is an addiction to tobacco products caused by the drug nicotine. It involves physical and psychological factors that make it difficult to stop using tobacco. […] Nicotine dependence (also called tobacco addiction) involves physical and psychological factors that make it difficult to stop using tobacco, even if the person wants to quit. […] Signs of physical dependence on nicotine include: the urge to smoke within 30 minutes of waking, ranking the first cigarette of the day as the most important, smoking at regular intervals throughout the day. […] Tobacco use causes feelings of pleasure and alertness, but people with nicotine dependence become tolerant to the desired effects. […] Signs and symptoms of nicotine withdrawal include: irritability, restlessness, anxiety, insomnia, difficulty concentrating, fatigue.

• #2 Nicotine dependence – Wikipedia

  https://en.wikipedia.org/wiki/Nicotine_dependence

  Nicotine dependence is a state of substance dependence on nicotine. It is a chronic, relapsing disease characterized by a compulsive craving to use the drug despite social consequences, loss of control over drug intake, and the emergence of withdrawal symptoms. Nicotine dependence is a serious public health problem because it leads to continued tobacco use and the associated negative health effects. Tobacco use is one of the leading preventable causes of death worldwide, causing more than 8 million deaths per year and killing half of its users who do not quit. Current smokers are estimated to die an average of 10 years earlier than non-smokers. […] According to the World Health Organization, „Greater nicotine dependence has been shown to be associated with lower motivation to quit, difficulty in trying to quit, and failure to quit, as well as with smoking the first cigarette earlier in the day and smoking more cigarettes per day.”

• #3 Nicotine Dependence | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/nicotine-dependence

  Nicotine has been proven to be as addictive as cocaine and heroin and may even be more addictive. Many people who smoke develop nicotine dependence, which makes quitting all the harder, especially when they try to stop smoking on their own. […] Quitting tobacco is one of the most important steps people can take for their health, but it is also extremely difficult. The good news is that tobacco addiction is treatable, and tobacco users who receive counseling and medication during their attempts to quit are much more likely to succeed than those who dont get such support. […] UCSF is home to a multifaceted tobacco treatment program, staffed by nurses, pharmacists and social workers who are trained in tobacco addiction. We offer one-on-one consultations, interactive classes and a follow-up support group to help class graduates stay or become tobacco free.

• #4 Tobacco Use: The Current State of Affairs and How Nurses Can Help Patients Quit | OJIN: The Online Journal of Issues in Nursing

  https://ojin.nursingworld.org/table-of-contents/volume-25-2020/number-3-september-2020/tobacco-use-the-current-state-of-affairs-and-how-nurses-can-help-patients-quit/

  Tobacco related illnesses may be avoided by preventing the initiation of ever smoking, and early intervention in the successful cessation of tobacco products. […] Nursing, represented by 4 million highly capable professionals practicing across the care continuum, constitutes critical resources toward this effort. […] Nicotine is one of the most addictive known substances. […] The symptomatic swings in nicotine blood concentration directly correlate with regular use and daily dosing of nicotine and the intolerability of nicotine withdrawal symptoms, which often lead to the resumption of nicotine use or relapse. […] Tobacco (nicotine) dependence is a chronic relapsing condition. […] Successful cessation is a process; nurses and other healthcare professionals must not give up on patients in the cessation journey.

• #5 Nicotine dependence – Wikipedia

  https://en.wikipedia.org/wiki/Nicotine_dependence

  Nicotine dependence is a state of substance dependence on nicotine. It is a chronic, relapsing disease characterized by a compulsive craving to use the drug despite social consequences, loss of control over drug intake, and the emergence of withdrawal symptoms. Nicotine dependence is a serious public health problem because it leads to continued tobacco use and the associated negative health effects. Tobacco use is one of the leading preventable causes of death worldwide, causing more than 8 million deaths per year and killing half of its users who do not quit. Current smokers are estimated to die an average of 10 years earlier than non-smokers. […] According to the World Health Organization, „Greater nicotine dependence has been shown to be associated with lower motivation to quit, difficulty in trying to quit, and failure to quit, as well as with smoking the first cigarette earlier in the day and smoking more cigarettes per day.”

• #6 Nicotine dependence | CAMH

  https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/nicotine-dependence

  Nicotine dependence is an addiction to tobacco products caused by the drug nicotine. It involves physical and psychological factors that make it difficult to stop using tobacco. […] Nicotine dependence (also called tobacco addiction) involves physical and psychological factors that make it difficult to stop using tobacco, even if the person wants to quit. […] Signs of physical dependence on nicotine include: the urge to smoke within 30 minutes of waking, ranking the first cigarette of the day as the most important, smoking at regular intervals throughout the day. […] Tobacco use causes feelings of pleasure and alertness, but people with nicotine dependence become tolerant to the desired effects. […] Signs and symptoms of nicotine withdrawal include: irritability, restlessness, anxiety, insomnia, difficulty concentrating, fatigue.

• #7 Nicotine dependence | CAMH

  https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/nicotine-dependence

  Nicotine dependence is an addiction to tobacco products caused by the drug nicotine. It involves physical and psychological factors that make it difficult to stop using tobacco. […] Nicotine dependence (also called tobacco addiction) involves physical and psychological factors that make it difficult to stop using tobacco, even if the person wants to quit. […] Signs of physical dependence on nicotine include: the urge to smoke within 30 minutes of waking, ranking the first cigarette of the day as the most important, smoking at regular intervals throughout the day. […] Tobacco use causes feelings of pleasure and alertness, but people with nicotine dependence become tolerant to the desired effects. […] Signs and symptoms of nicotine withdrawal include: irritability, restlessness, anxiety, insomnia, difficulty concentrating, fatigue.

• #8 Nicotine dependence | CAMH

  https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/nicotine-dependence

  Nicotine dependence is an addiction to tobacco products caused by the drug nicotine. It involves physical and psychological factors that make it difficult to stop using tobacco. […] Nicotine dependence (also called tobacco addiction) involves physical and psychological factors that make it difficult to stop using tobacco, even if the person wants to quit. […] Signs of physical dependence on nicotine include: the urge to smoke within 30 minutes of waking, ranking the first cigarette of the day as the most important, smoking at regular intervals throughout the day. […] Tobacco use causes feelings of pleasure and alertness, but people with nicotine dependence become tolerant to the desired effects. […] Signs and symptoms of nicotine withdrawal include: irritability, restlessness, anxiety, insomnia, difficulty concentrating, fatigue.

• #9 Tobacco and Nicotine Use Cessation | ANA Enterprise

  https://www.nursingworld.org/practice-policy/work-environment/health-safety/tobacco-free-nurses/

  As the largest group of health care professionals, nurses have tremendous potential to effectively implement smoking and nicotine cessation interventions and advance tobacco use reduction goals proposed by Healthy People 2020. […] By leading healthier lives, nurses inspire patients to make healthier choices, including the cessation of smoking. […] Do you have a patient who wants to stop smoking or using tobacco? Do you want to help patients who you know are smokers to quit smoking? This quick reference guide can help. […] Tobacco Cessation Webinar for CE for Nurses and Clinicians – Learn more about tobacco and ways to quit using it. Available until February 2021. […] For support in quitting visit CDCs Quit Smoking Resources page to access free quit coaching, a free quit plan, free educational materials and referrals to local resources, call 1-800-QUIT-NOW (1-800-784-8669).

• #10 Using evidence-based guidelines to help patients stop smoking

  https://www.myamericannurse.com/using-evidence-based-guidelines-to-help-patients-stop-smoking/

  No matter where you work, youre likely to encounter many patients with tobacco-related illnesses, which kill at least 440,000 Americans annually. Treating tobacco use and dependence is no longer optional. Helping smokers quit is now an expected part of good nursing care. […] The American Nurses Association urges all nurses to provide tobacco-dependence treatment and to engage in other aspects of tobacco use prevention and control. […] If you care for hospitalized patients who smoke, you may observe nicotine withdrawal symptoms. If youre able to distinguish these from symptoms related to the underlying cause of hospitalization, you can develop a care plan that addresses the patients smoking-related needs. […] The first step in helping patients stop smoking is to identify and document the smoking status of all patients. For those who smoke, the PHS guideline recommends a combination of pharmacotherapy and counseling for behavior modification as the most effective strategy to help smokers quit. […] Helping patients quit smoking is one of the most important things you can do to protect a patients health. If each of the 2.9 million nurses in the United States could help four smokers quit smoking, we could reach 11.6 million smokersapproximately 25% of U.S. smokers.

• #11 Using evidence-based guidelines to help patients stop smoking

  https://www.myamericannurse.com/using-evidence-based-guidelines-to-help-patients-stop-smoking/

  No matter where you work, youre likely to encounter many patients with tobacco-related illnesses, which kill at least 440,000 Americans annually. Treating tobacco use and dependence is no longer optional. Helping smokers quit is now an expected part of good nursing care. […] The American Nurses Association urges all nurses to provide tobacco-dependence treatment and to engage in other aspects of tobacco use prevention and control. […] If you care for hospitalized patients who smoke, you may observe nicotine withdrawal symptoms. If youre able to distinguish these from symptoms related to the underlying cause of hospitalization, you can develop a care plan that addresses the patients smoking-related needs. […] The first step in helping patients stop smoking is to identify and document the smoking status of all patients. For those who smoke, the PHS guideline recommends a combination of pharmacotherapy and counseling for behavior modification as the most effective strategy to help smokers quit. […] Helping patients quit smoking is one of the most important things you can do to protect a patients health. If each of the 2.9 million nurses in the United States could help four smokers quit smoking, we could reach 11.6 million smokersapproximately 25% of U.S. smokers.

• #12 Using evidence-based guidelines to help patients stop smoking

  https://www.myamericannurse.com/using-evidence-based-guidelines-to-help-patients-stop-smoking/

  No matter where you work, youre likely to encounter many patients with tobacco-related illnesses, which kill at least 440,000 Americans annually. Treating tobacco use and dependence is no longer optional. Helping smokers quit is now an expected part of good nursing care. […] The American Nurses Association urges all nurses to provide tobacco-dependence treatment and to engage in other aspects of tobacco use prevention and control. […] If you care for hospitalized patients who smoke, you may observe nicotine withdrawal symptoms. If youre able to distinguish these from symptoms related to the underlying cause of hospitalization, you can develop a care plan that addresses the patients smoking-related needs. […] The first step in helping patients stop smoking is to identify and document the smoking status of all patients. For those who smoke, the PHS guideline recommends a combination of pharmacotherapy and counseling for behavior modification as the most effective strategy to help smokers quit. […] Helping patients quit smoking is one of the most important things you can do to protect a patients health. If each of the 2.9 million nurses in the United States could help four smokers quit smoking, we could reach 11.6 million smokersapproximately 25% of U.S. smokers.

• #13 Nicotine Addiction and Smoking: Health Effects and Interventions (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568714/

  There are several nursing diagnoses that can be used for tobacco cessation, such as: […] Ineffective Therapeutic Regimen Management: Pattern of regulating and integrating into daily living a program for the treatment of illness and the sequelae of illness that is unsatisfactory for meeting specific health goals. Tobacco use is an unsatisfactory daily activity that leads to negative health outcomes. […] Anxiety: Vague uneasy feeling of discomfort or dread accompanied by an autonomic response. Withdrawal from nicotine, an addictive substance, can lead to anxiety. […] Deficient Knowledge: Absence or deficiency of cognitive information related to specific topic. Communities, families, and individuals require an understanding of the addictive nature of tobacco use and its accompanied negative health effects.

• #14 Nicotine Addiction and Smoking: Health Effects and Interventions (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568714/

  Short term outcomes should be for the individual to express a desire to quit using tobacco products; to refrain from smoking around others, especially infants and children; and to enroll in a cessation program. Long term outcomes are to remain tobacco-free, thus eliminating exposure to the individual and others. […] Management and control of tobacco use is four-fold: 1) cessation programs, 2) preventing children and adolescents from smoking, 3) preventing exposure to second-hand smoke, and 4) advocacy to change attitudes toward smoking. Nurses in various roles, such as school nursing, occupational health, community health, obstetrics, medical-surgical, and research are responsible to assess and intervene to decrease the negative health impact of tobacco. […] Daily cigarette smokers keep smoking because they are physically addicted to nicotine, a substance that is naturally found in tobacco leaves.

• #15 Nicotine Addiction and Smoking: Health Effects and Interventions (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568714/

  Short term outcomes should be for the individual to express a desire to quit using tobacco products; to refrain from smoking around others, especially infants and children; and to enroll in a cessation program. Long term outcomes are to remain tobacco-free, thus eliminating exposure to the individual and others. […] Management and control of tobacco use is four-fold: 1) cessation programs, 2) preventing children and adolescents from smoking, 3) preventing exposure to second-hand smoke, and 4) advocacy to change attitudes toward smoking. Nurses in various roles, such as school nursing, occupational health, community health, obstetrics, medical-surgical, and research are responsible to assess and intervene to decrease the negative health impact of tobacco. […] Daily cigarette smokers keep smoking because they are physically addicted to nicotine, a substance that is naturally found in tobacco leaves.

• #16 Nursing Diagnosis for Substance Abuse: 8 Care Plans – Nurseslabs

  https://nurseslabs.com/substance-abuse-nursing-diagnosis-care-plan/

  The following are the nursing priorities for patients with substance abuse: Ensure safety and monitor for withdrawal symptoms, Provide education on substance abuse and its effects, Assist in developing coping skills and relapse prevention strategies, Facilitate access to appropriate treatment programs and resources, Support the patients physical and emotional well-being, Address any co-occurring mental health issues, Encourage participation in support groups or counseling. […] Following a thorough assessment, a nursing diagnosis is formulated to specifically address the challenges associated with substance abuse based on the nurses clinical judgment and understanding of the patients unique health condition. […] Goals and expected outcomes may include: The client will verbalize awareness of the relationship between substance abuse and the current situation, The client will verbalize acceptance of responsibility for their own behavior, The client will identify ineffective coping behaviors/consequences, including the use of substances as a method of coping, The client will admit the inability to control their drug habit and surrender to powerlessness over addiction, The client will verbalize acceptance of the need for treatment and awareness that willpower alone cannot control abstinence, The client will demonstrate active participation in the program, The client will regain and maintain a healthy state with a drug-free lifestyle.

• #17

  https://journals.lww.com/10.4103/jin.jin_110_24

  Nursing interventions for tobacco cessation are comprehensive and encompass a range of strategies that address both the physical and psychological challenges associated with quitting. These strategies include thorough patient assessment, where nurses evaluate the individuals smoking habits, history, and motivations for quitting. Counseling is another core component, often utilizing motivational interviewing (MI) techniques to help patients explore their ambivalence toward quitting and strengthen their commitment to change. […] The 5 As framework comprising Ask, Advise, Assess, Assist, and Arrange provides a systematic and comprehensive approach for nurses to facilitate tobacco cessation counseling effectively. […] Pharmacotherapy support is a crucial component of tobacco cessation efforts, providing patients with the necessary tools to manage withdrawal symptoms and cravings effectively. Nurses play a pivotal role in this process, offering education, monitoring, and encouragement to ensure the successful use of pharmacological aids.

• #18

  https://journals.lww.com/10.4103/jin.jin_110_24

  Nursing interventions for tobacco cessation are comprehensive and encompass a range of strategies that address both the physical and psychological challenges associated with quitting. These strategies include thorough patient assessment, where nurses evaluate the individuals smoking habits, history, and motivations for quitting. Counseling is another core component, often utilizing motivational interviewing (MI) techniques to help patients explore their ambivalence toward quitting and strengthen their commitment to change. […] The 5 As framework comprising Ask, Advise, Assess, Assist, and Arrange provides a systematic and comprehensive approach for nurses to facilitate tobacco cessation counseling effectively. […] Pharmacotherapy support is a crucial component of tobacco cessation efforts, providing patients with the necessary tools to manage withdrawal symptoms and cravings effectively. Nurses play a pivotal role in this process, offering education, monitoring, and encouragement to ensure the successful use of pharmacological aids.

• #19 Using evidence-based guidelines to help patients stop smoking

  https://www.myamericannurse.com/using-evidence-based-guidelines-to-help-patients-stop-smoking/

  No matter where you work, youre likely to encounter many patients with tobacco-related illnesses, which kill at least 440,000 Americans annually. Treating tobacco use and dependence is no longer optional. Helping smokers quit is now an expected part of good nursing care. […] The American Nurses Association urges all nurses to provide tobacco-dependence treatment and to engage in other aspects of tobacco use prevention and control. […] If you care for hospitalized patients who smoke, you may observe nicotine withdrawal symptoms. If youre able to distinguish these from symptoms related to the underlying cause of hospitalization, you can develop a care plan that addresses the patients smoking-related needs. […] The first step in helping patients stop smoking is to identify and document the smoking status of all patients. For those who smoke, the PHS guideline recommends a combination of pharmacotherapy and counseling for behavior modification as the most effective strategy to help smokers quit. […] Helping patients quit smoking is one of the most important things you can do to protect a patients health. If each of the 2.9 million nurses in the United States could help four smokers quit smoking, we could reach 11.6 million smokersapproximately 25% of U.S. smokers.

• #20 Clinical Interventions to Treat Tobacco Use and Dependence Among Adults | Smoking and Tobacco Use | CDC

  https://www.cdc.gov/tobacco/hcp/patient-care-settings/clinical.html

  Bupropion is a dopamine and norepinephrine reuptake inhibitor with nicotine receptor antagonist properties. It reduces craving and other withdrawal symptoms and is available by prescription only. […] Counseling and medication are effective on their own, but using them together can more than double the chances of quitting. […] Combining long-acting NRT (patch) with short-acting NRT (e.g., gum, lozenge) also increases the chances of quitting. […] A team approach is the best way to treat tobacco use and dependence. Integrating treatment into the routine clinical workflow and engaging the entire health care team in treatment delivery can make a difference. […] Talk to patients at every visit about their tobacco use. Even brief advice can influence a patient’s decision to quit smoking. […] Advise patients that quitting is one of the most important things they can do to improve their health and prognosis. Advise pregnant patients that quitting is one of the most important things they can do to improve their health and the health of their baby.

• #21 Clinical Interventions to Treat Tobacco Use and Dependence Among Adults | Smoking and Tobacco Use | CDC

  https://www.cdc.gov/tobacco/hcp/patient-care-settings/clinical.html

  Remind patients that it is never too late to quit smoking. Quitting is beneficial at any age. For pregnant patients, remind them, although smoking cessation at any point during pregnancy yields health benefits, quitting early in pregnancy provides the greatest benefit to mother and baby. […] Offer patients a combination of counseling and medications. […] Refer patients to cessation resources and programs in your health system and community. You can also refer them to telephone quitlines (1-800-QUIT-NOW) and text messaging (e.g., SmokefreeTXT) and web-based interventions (e.g., cdc.gov/quit and smokfree.gov). […] Assess your patients’ progress over time and provide additional support. It may take several attempts for them to quit smoking. […] Provide ongoing support and encourage patients to keep trying and not give up.

• #22 Clinical Interventions to Treat Tobacco Use and Dependence Among Adults | Smoking and Tobacco Use | CDC

  https://www.cdc.gov/tobacco/hcp/patient-care-settings/clinical.html

  Remind patients that it is never too late to quit smoking. Quitting is beneficial at any age. For pregnant patients, remind them, although smoking cessation at any point during pregnancy yields health benefits, quitting early in pregnancy provides the greatest benefit to mother and baby. […] Offer patients a combination of counseling and medications. […] Refer patients to cessation resources and programs in your health system and community. You can also refer them to telephone quitlines (1-800-QUIT-NOW) and text messaging (e.g., SmokefreeTXT) and web-based interventions (e.g., cdc.gov/quit and smokfree.gov). […] Assess your patients’ progress over time and provide additional support. It may take several attempts for them to quit smoking. […] Provide ongoing support and encourage patients to keep trying and not give up.

• #23 Clinical Interventions to Treat Tobacco Use and Dependence Among Adults | Smoking and Tobacco Use | CDC

  https://www.cdc.gov/tobacco/hcp/patient-care-settings/clinical.html

  Remind patients that it is never too late to quit smoking. Quitting is beneficial at any age. For pregnant patients, remind them, although smoking cessation at any point during pregnancy yields health benefits, quitting early in pregnancy provides the greatest benefit to mother and baby. […] Offer patients a combination of counseling and medications. […] Refer patients to cessation resources and programs in your health system and community. You can also refer them to telephone quitlines (1-800-QUIT-NOW) and text messaging (e.g., SmokefreeTXT) and web-based interventions (e.g., cdc.gov/quit and smokfree.gov). […] Assess your patients’ progress over time and provide additional support. It may take several attempts for them to quit smoking. […] Provide ongoing support and encourage patients to keep trying and not give up.

• #24

  https://journals.lww.com/10.4103/jin.jin_110_24

  Nursing interventions for tobacco cessation are comprehensive and encompass a range of strategies that address both the physical and psychological challenges associated with quitting. These strategies include thorough patient assessment, where nurses evaluate the individuals smoking habits, history, and motivations for quitting. Counseling is another core component, often utilizing motivational interviewing (MI) techniques to help patients explore their ambivalence toward quitting and strengthen their commitment to change. […] The 5 As framework comprising Ask, Advise, Assess, Assist, and Arrange provides a systematic and comprehensive approach for nurses to facilitate tobacco cessation counseling effectively. […] Pharmacotherapy support is a crucial component of tobacco cessation efforts, providing patients with the necessary tools to manage withdrawal symptoms and cravings effectively. Nurses play a pivotal role in this process, offering education, monitoring, and encouragement to ensure the successful use of pharmacological aids.

• #25 Nicotine dependence – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nicotine-dependence/diagnosis-treatment/drc-20351590

  Your doctor may ask you questions or have you fill out a questionnaire to see how dependent you are on nicotine. Knowing your degree of dependence will help your doctor determine the right treatment plan for you. The more cigarettes you smoke each day and the sooner you smoke after awakening, the more dependent you are. […] You’re much more likely to be able to stop smoking if you use medications and counseling, which have both been proved effective, especially in combination. […] Any of these products can help reduce nicotine cravings and withdrawal symptoms making it more likely that you’ll stop smoking for good. Using more than one may help you get better results. […] Medications help you cope by reducing withdrawal symptoms and cravings, while behavioral treatments help you develop the skills you need to give up tobacco for good. The more time you spend with a counselor, the better your treatment results will be.

• #26

  https://journals.lww.com/10.4103/jin.jin_110_24

  Behavioral interventions are essential for supporting individuals in their journey to quit smoking, focusing on modifying behaviors and thought patterns associated with tobacco use. These interventions equip patients with skills to manage cravings and triggers effectively, enhancing their chances of successfully quitting.

• #27 Clinical Interventions to Treat Tobacco Use and Dependence Among Adults | Smoking and Tobacco Use | CDC

  https://www.cdc.gov/tobacco/hcp/patient-care-settings/clinical.html

  Tobacco use and dependence is a chronic, relapsing condition that often requires repeated intervention and long-term support. Quitting can be hard, but evidence-based treatments improve success. Below are clinical interventions that work to help adult patients quit smoking. […] Counseling can be in person (one-on-one or in a group) or over a telephone quitline. […] Text messaging (e.g., SmokefreeTXT) and web-based interventions (e.g., cdc.gov/quit and smokfree.gov) also help people quit smoking. […] Seven medications are approved by the U.S. Food and Drug Administration (FDA) for smoking cessation. […] Nicotine Replacement Therapy (NRT) reduces nicotine withdrawal symptoms and is available over the counter (patch, gum, and lozenge) and by prescription (inhaler and nasal spray). […] Varenicline is a nicotine receptor partial agonist available only by prescription. It reduces nicotine withdrawal symptoms (including craving) and reduces the rewarding effects of cigarettes by blocking nicotinic receptors.

• #28 Clinical Interventions to Treat Tobacco Use and Dependence Among Adults | Smoking and Tobacco Use | CDC

  https://www.cdc.gov/tobacco/hcp/patient-care-settings/clinical.html

  Bupropion is a dopamine and norepinephrine reuptake inhibitor with nicotine receptor antagonist properties. It reduces craving and other withdrawal symptoms and is available by prescription only. […] Counseling and medication are effective on their own, but using them together can more than double the chances of quitting. […] Combining long-acting NRT (patch) with short-acting NRT (e.g., gum, lozenge) also increases the chances of quitting. […] A team approach is the best way to treat tobacco use and dependence. Integrating treatment into the routine clinical workflow and engaging the entire health care team in treatment delivery can make a difference. […] Talk to patients at every visit about their tobacco use. Even brief advice can influence a patient’s decision to quit smoking. […] Advise patients that quitting is one of the most important things they can do to improve their health and prognosis. Advise pregnant patients that quitting is one of the most important things they can do to improve their health and the health of their baby.

• #29

  https://journals.lww.com/10.4103/jin.jin_110_24

  Nursing interventions for tobacco cessation are comprehensive and encompass a range of strategies that address both the physical and psychological challenges associated with quitting. These strategies include thorough patient assessment, where nurses evaluate the individuals smoking habits, history, and motivations for quitting. Counseling is another core component, often utilizing motivational interviewing (MI) techniques to help patients explore their ambivalence toward quitting and strengthen their commitment to change. […] The 5 As framework comprising Ask, Advise, Assess, Assist, and Arrange provides a systematic and comprehensive approach for nurses to facilitate tobacco cessation counseling effectively. […] Pharmacotherapy support is a crucial component of tobacco cessation efforts, providing patients with the necessary tools to manage withdrawal symptoms and cravings effectively. Nurses play a pivotal role in this process, offering education, monitoring, and encouragement to ensure the successful use of pharmacological aids.

• #30 Nicotine dependence – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nicotine-dependence/diagnosis-treatment/drc-20351590

  Your doctor may ask you questions or have you fill out a questionnaire to see how dependent you are on nicotine. Knowing your degree of dependence will help your doctor determine the right treatment plan for you. The more cigarettes you smoke each day and the sooner you smoke after awakening, the more dependent you are. […] You’re much more likely to be able to stop smoking if you use medications and counseling, which have both been proved effective, especially in combination. […] Any of these products can help reduce nicotine cravings and withdrawal symptoms making it more likely that you’ll stop smoking for good. Using more than one may help you get better results. […] Medications help you cope by reducing withdrawal symptoms and cravings, while behavioral treatments help you develop the skills you need to give up tobacco for good. The more time you spend with a counselor, the better your treatment results will be.

• #31 Nicotine Addiction and Smoking: Health Effects and Interventions (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568714/

  Brief interventions on admission to the hospital include assessment of tobacco use; offering nicotine replacement while hospitalized, assessing if a patient is interested in cessation and referring them to counselling if needed. […] Smokers who are addicted to nicotine will have withdrawal symptoms if not allowed to use tobacco products while hospitalized, including anxiety, vertigo, mood swings, and a general feeling of uneasiness. […] Nurses, especially nurses in Community Health should be involved in tobacco control, including prevention, second hand smoke avoidance, and advocacy. […] Discharge planning for all tobacco users should include a patient-centered plan for cessation. Medications are available to aid in cessation and should be prescribed by the provider. […] Tobacco use is a preventable cause of morbidity and mortality and nurses are in a unique position to assist in the campaign to end suffering from tobacco use and nicotine addiction. […] Nurses and the entire healthcare team are expected to advocate cessation and prevention in individuals and communities through use of evidence based assessments, interventions, and evaluation of the impact of tobacco.

• #32

  https://journals.lww.com/10.4103/jin.jin_110_24

  Nursing interventions for tobacco cessation are comprehensive and encompass a range of strategies that address both the physical and psychological challenges associated with quitting. These strategies include thorough patient assessment, where nurses evaluate the individuals smoking habits, history, and motivations for quitting. Counseling is another core component, often utilizing motivational interviewing (MI) techniques to help patients explore their ambivalence toward quitting and strengthen their commitment to change. […] The 5 As framework comprising Ask, Advise, Assess, Assist, and Arrange provides a systematic and comprehensive approach for nurses to facilitate tobacco cessation counseling effectively. […] Pharmacotherapy support is a crucial component of tobacco cessation efforts, providing patients with the necessary tools to manage withdrawal symptoms and cravings effectively. Nurses play a pivotal role in this process, offering education, monitoring, and encouragement to ensure the successful use of pharmacological aids.

• #33 Clinical Interventions to Treat Tobacco Use and Dependence Among Adults | Smoking and Tobacco Use | CDC

  https://www.cdc.gov/tobacco/hcp/patient-care-settings/clinical.html

  Tobacco use and dependence is a chronic, relapsing condition that often requires repeated intervention and long-term support. Quitting can be hard, but evidence-based treatments improve success. Below are clinical interventions that work to help adult patients quit smoking. […] Counseling can be in person (one-on-one or in a group) or over a telephone quitline. […] Text messaging (e.g., SmokefreeTXT) and web-based interventions (e.g., cdc.gov/quit and smokfree.gov) also help people quit smoking. […] Seven medications are approved by the U.S. Food and Drug Administration (FDA) for smoking cessation. […] Nicotine Replacement Therapy (NRT) reduces nicotine withdrawal symptoms and is available over the counter (patch, gum, and lozenge) and by prescription (inhaler and nasal spray). […] Varenicline is a nicotine receptor partial agonist available only by prescription. It reduces nicotine withdrawal symptoms (including craving) and reduces the rewarding effects of cigarettes by blocking nicotinic receptors.

• #34 What are treatments for tobacco dependence? | National Institute on Drug Abuse (NIDA)

  https://nida.nih.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/what-are-treatments-tobacco-dependence

  There are effective treatments that support tobacco cessation, including both behavioral therapies and FDA-approved medications. […] The prevalence of tobacco use and dependence among adolescents as well as the neurobiological impact and medical consequences of nicotine exposure suggest that pediatric primary care settings should deliver tobacco cessation treatments to both youth and parents who use tobacco. […] More well-designed smoking cessation studies need to be conducted with adolescent smokers, particularly in the area of pharmacologic treatments for nicotine dependence. […] A variety of formulations of nicotine NRTs are available over the counter including the transdermal patch, spray, gum, and lozenges and are equally effective for cessation. […] NRTs stimulate the brain receptors targeted by nicotine, helping relieve nicotine withdrawal symptoms and cravings that lead to relapse.

• #35 Clinical Interventions to Treat Tobacco Use and Dependence Among Adults | Smoking and Tobacco Use | CDC

  https://www.cdc.gov/tobacco/hcp/patient-care-settings/clinical.html

  Tobacco use and dependence is a chronic, relapsing condition that often requires repeated intervention and long-term support. Quitting can be hard, but evidence-based treatments improve success. Below are clinical interventions that work to help adult patients quit smoking. […] Counseling can be in person (one-on-one or in a group) or over a telephone quitline. […] Text messaging (e.g., SmokefreeTXT) and web-based interventions (e.g., cdc.gov/quit and smokfree.gov) also help people quit smoking. […] Seven medications are approved by the U.S. Food and Drug Administration (FDA) for smoking cessation. […] Nicotine Replacement Therapy (NRT) reduces nicotine withdrawal symptoms and is available over the counter (patch, gum, and lozenge) and by prescription (inhaler and nasal spray). […] Varenicline is a nicotine receptor partial agonist available only by prescription. It reduces nicotine withdrawal symptoms (including craving) and reduces the rewarding effects of cigarettes by blocking nicotinic receptors.

• #36 Clinical Interventions to Treat Tobacco Use and Dependence Among Adults | Smoking and Tobacco Use | CDC

  https://www.cdc.gov/tobacco/hcp/patient-care-settings/clinical.html

  Bupropion is a dopamine and norepinephrine reuptake inhibitor with nicotine receptor antagonist properties. It reduces craving and other withdrawal symptoms and is available by prescription only. […] Counseling and medication are effective on their own, but using them together can more than double the chances of quitting. […] Combining long-acting NRT (patch) with short-acting NRT (e.g., gum, lozenge) also increases the chances of quitting. […] A team approach is the best way to treat tobacco use and dependence. Integrating treatment into the routine clinical workflow and engaging the entire health care team in treatment delivery can make a difference. […] Talk to patients at every visit about their tobacco use. Even brief advice can influence a patient’s decision to quit smoking. […] Advise patients that quitting is one of the most important things they can do to improve their health and prognosis. Advise pregnant patients that quitting is one of the most important things they can do to improve their health and the health of their baby.

• #37 Clinical Interventions to Treat Tobacco Use and Dependence Among Adults | Smoking and Tobacco Use | CDC

  https://www.cdc.gov/tobacco/hcp/patient-care-settings/clinical.html

  Bupropion is a dopamine and norepinephrine reuptake inhibitor with nicotine receptor antagonist properties. It reduces craving and other withdrawal symptoms and is available by prescription only. […] Counseling and medication are effective on their own, but using them together can more than double the chances of quitting. […] Combining long-acting NRT (patch) with short-acting NRT (e.g., gum, lozenge) also increases the chances of quitting. […] A team approach is the best way to treat tobacco use and dependence. Integrating treatment into the routine clinical workflow and engaging the entire health care team in treatment delivery can make a difference. […] Talk to patients at every visit about their tobacco use. Even brief advice can influence a patient’s decision to quit smoking. […] Advise patients that quitting is one of the most important things they can do to improve their health and prognosis. Advise pregnant patients that quitting is one of the most important things they can do to improve their health and the health of their baby.

• #38 Nicotine Addiction and Smoking: Health Effects and Interventions (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568714/

  Brief interventions on admission to the hospital include assessment of tobacco use; offering nicotine replacement while hospitalized, assessing if a patient is interested in cessation and referring them to counselling if needed. […] Smokers who are addicted to nicotine will have withdrawal symptoms if not allowed to use tobacco products while hospitalized, including anxiety, vertigo, mood swings, and a general feeling of uneasiness. […] Nurses, especially nurses in Community Health should be involved in tobacco control, including prevention, second hand smoke avoidance, and advocacy. […] Discharge planning for all tobacco users should include a patient-centered plan for cessation. Medications are available to aid in cessation and should be prescribed by the provider. […] Tobacco use is a preventable cause of morbidity and mortality and nurses are in a unique position to assist in the campaign to end suffering from tobacco use and nicotine addiction. […] Nurses and the entire healthcare team are expected to advocate cessation and prevention in individuals and communities through use of evidence based assessments, interventions, and evaluation of the impact of tobacco.

• #39 Smoking: Nursing Diagnoses & Care Plans | NurseTogether

  https://www.nursetogether.com/smoking-nursing-diagnosis-care-plan/

  Smoking cessation is difficult to achieve. Nurses play an important role in providing counseling and education on medications as these are proven effective methods in smoking cessation. […] Nicotine replacement therapy products contain varying amounts of nicotine and are effective in reducing nicotine cravings as well as withdrawal symptoms. Behavioral therapy and support are essential in helping smokers develop skills to give up cigarette smoking for good. […] Once the nurse identifies nursing diagnoses related to smoking, nursing care plans help prioritize assessments and interventions for both short and long-term goals of care. […] Patients who smoke exhibit ineffective health maintenance behaviors as they fail to maintain their physical, mental, spiritual, or mental health. […] The patient will agree to and participate in a place of action to quit smoking.

• #40 Addressing Nicotine Dependence in Patients with Mental Health Concerns and/or Substance Use Disorders

  https://behavioralhealthnews.org/addressing-nicotine-dependence-in-patients-with-mental-health-concerns-and-or-substance-use-disorders/

  Tobacco use remains the leading cause of preventable disease and death in the United States, accounting for approximately one in five deaths. An estimated 11.5% of U.S. adults are current cigarette smokers. That translates to 28.3 million adults in our country who are currently smoking. More than 16 million Americans are living with smoking-related disease. Interestingly, the rates of cigarette smoking have actually declined significantly over the past 40 years, except among those with mental health or substance use disorders. […] […] The nicotine dependency rate for individuals with behavioral health disorders is two to three times higher than the general population. And smoking rates are particularly high among people with serious mental illness. People with a mental health disorder who smoke are also likely to smoke more than those in the general population, putting them at an even greater risk. While estimates differ, as many as 70-85% of people with schizophrenia and as many as 50-70% of people with bipolar disorder smoke. Individuals with alcohol use disorders smoke at rates between 34 and 80%. And people with other substance use disorders smoke at rates between 49 and 98%. […]

• #41 Addressing Nicotine Dependence in Patients with Mental Health Concerns and/or Substance Use Disorders

  https://behavioralhealthnews.org/addressing-nicotine-dependence-in-patients-with-mental-health-concerns-and-or-substance-use-disorders/

  Yet, its been proven that smoking cessation correlates with an improvement in mental health, including a decrease in depression, anxiety, and stress, and overall improvement in mood and quality of life. Furthermore, research has illustrated that smoking is actually associated with worse behavioral and physical health outcomes in people with mental illness, and that quitting smoking has clear benefits, including improving mental health. […] […] Comprehensive tobacco control programs and enhanced efforts to prevent and treat nicotine addiction among those with mental illness and substance use disorders reduces morbidity and mortality. And despite the common myth that those in treatment for mental health and/or substance use disorders cannot address nicotine dependence at the same time or risk relapse by doing so, research shows that integrated treatment, with concurrent therapy for mental illness and nicotine addiction, proves to have the best outcomes. […]

• #42 Addressing Nicotine Dependence in Patients with Mental Health Concerns and/or Substance Use Disorders

  https://behavioralhealthnews.org/addressing-nicotine-dependence-in-patients-with-mental-health-concerns-and-or-substance-use-disorders/

  Systemic, evidence-based screening and treatment of tobacco dependence is integral to improving patient health outcomes. These standards are in alignment with the US Public Health Services Clinical Practice Guideline Treating Tobacco Use and Dependence: 2008 update, which includes best practice systems strategies for organizations to use with their clientele.

• #43 Nicotine Addiction Treatment & Management: Approach Considerations, Counseling, Nicotine Replacement Therapy

  https://emedicine.medscape.com/article/287555-treatment

  Bupropion acts by alleviating some of the symptoms of nicotine withdrawal, which include depression. […] Compared with placebo, bupropion approximately doubles smoking cessation rates, and it is equally effective for men and women. […] Varenicline helps smokers quit by preventing withdrawal symptoms while moderate levels of dopamine are maintained in the brain. […] The main adverse effect of varenicline was nausea, which was mostly mild to moderate and usually subsided over time. […] Highly nicotine-dependent smokers may require initial therapy for 6 months or longer. Some individuals may require low-dose maintenance therapy for years. […] Long-term follow-up is recommended because individuals who successfully quit smoking are at high risk for relapse.

• #44 Behavioral Health and Tobacco Cessation | AAFP

  https://www.aafp.org/family-physician/patient-care/care-resources/tobacco-and-nicotine/office-champions/behavioral-health-tobacco-cessation.html

  For individuals who have a mental health disorder, smoking cigarettes can reduce the therapeutic blood levels of a number of psychiatric medications, thereby decreasing their effectiveness. […] The U.S. Public Health Service (USPHS) clinical practice guideline, Treating Tobacco Use and Dependence: 2008 Update, calls on physicians to change the clinical culture and practice patterns to ensure that every patient who uses tobacco is identified, advised to quit, and offered scientifically sound treatments. […] The American Academy of Family Physicians (AAFP) encourages family physicians to use interventions drawn from behavioral health care to address tobacco and nicotine dependence. Recommended interventions include motivational interviewing, brief interventions, and group visits. […] The evidence-based interventions described in these resources can be used with any patient who smokes, not just patients who have a behavioral health disorder. However, counseling and pharmacotherapy must be tailored to the needs of the individual patient. Patients who have a behavioral health disorder will often require more time to prepare to quit, more medical management, more intensive follow up, and closer medication monitoring than other patients.

• #45 Addressing Nicotine Dependence in Patients with Mental Health Concerns and/or Substance Use Disorders

  https://behavioralhealthnews.org/addressing-nicotine-dependence-in-patients-with-mental-health-concerns-and-or-substance-use-disorders/

  Yet, its been proven that smoking cessation correlates with an improvement in mental health, including a decrease in depression, anxiety, and stress, and overall improvement in mood and quality of life. Furthermore, research has illustrated that smoking is actually associated with worse behavioral and physical health outcomes in people with mental illness, and that quitting smoking has clear benefits, including improving mental health. […] […] Comprehensive tobacco control programs and enhanced efforts to prevent and treat nicotine addiction among those with mental illness and substance use disorders reduces morbidity and mortality. And despite the common myth that those in treatment for mental health and/or substance use disorders cannot address nicotine dependence at the same time or risk relapse by doing so, research shows that integrated treatment, with concurrent therapy for mental illness and nicotine addiction, proves to have the best outcomes. […]

• #46 Tobacco and Nicotine Cessation During Pregnancy | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/05/tobacco-and-nicotine-cessation-during-pregnancy

  Pregnant women should be advised of the significant perinatal risks associated with tobacco use, including orofacial clefts, fetal growth restriction, placenta previa, abruptio placentae, preterm prelabor rupture of membranes, low birth weight, increased perinatal mortality, ectopic pregnancy, and decreased maternal thyroid function. […] Smoking cessation at any point in gestation benefits the pregnant woman and her fetus. […] Clinicians should individualize care by offering psychosocial, behavioral, and pharmacotherapy interventions. […] Providing continual support and addressing psychosocial stressors in the postpartum period are necessary to ensure continued cessation success. […] Addiction to and dependence on cigarettes is physiologic and psychologic, and cessation techniques should include psychosocial interventions and pharmacologic therapy.

• #47 Tobacco and Nicotine Cessation During Pregnancy | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/05/tobacco-and-nicotine-cessation-during-pregnancy

  Pregnant women should be advised of the significant perinatal risks associated with tobacco use, including orofacial clefts, fetal growth restriction, placenta previa, abruptio placentae, preterm prelabor rupture of membranes, low birth weight, increased perinatal mortality, ectopic pregnancy, and decreased maternal thyroid function. […] Smoking cessation at any point in gestation benefits the pregnant woman and her fetus. […] Clinicians should individualize care by offering psychosocial, behavioral, and pharmacotherapy interventions. […] Providing continual support and addressing psychosocial stressors in the postpartum period are necessary to ensure continued cessation success. […] Addiction to and dependence on cigarettes is physiologic and psychologic, and cessation techniques should include psychosocial interventions and pharmacologic therapy.

• #48 Tobacco and Nicotine Cessation During Pregnancy | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/05/tobacco-and-nicotine-cessation-during-pregnancy

  Counseling, financial incentives, and feedback-based interventions such as cognitive behavioral therapy are associated with a reduction in smoking during pregnancy and decreased risk for infants with low birth weight. […] Women who indicate that they are not ready to quit smoking can benefit from consistent motivational approaches provided by their health care professionals. […] Clinicians should individualize care by offering psychosocial, behavioral, and pharmacotherapy interventions. […] Although counseling and pregnancy-specific materials are effective cessation aids for many pregnant women, some women continue to use tobacco products. […] The U.S. Preventive Services Task Force has concluded that current evidence is insufficient to assess the balance of benefits and harms of nicotine replacement products or other pharmaceuticals for tobacco cessation during pregnancy. […] Obstetrician-gynecologists and other obstetric care professionals should counsel women about the risks of smoking and the benefits of cessation and discuss the resources available to help with smoking cessation, which may include the use of varenicline and bupropion.

• #49 Tobacco and Nicotine Cessation During Pregnancy | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/05/tobacco-and-nicotine-cessation-during-pregnancy

  Counseling, financial incentives, and feedback-based interventions such as cognitive behavioral therapy are associated with a reduction in smoking during pregnancy and decreased risk for infants with low birth weight. […] Women who indicate that they are not ready to quit smoking can benefit from consistent motivational approaches provided by their health care professionals. […] Clinicians should individualize care by offering psychosocial, behavioral, and pharmacotherapy interventions. […] Although counseling and pregnancy-specific materials are effective cessation aids for many pregnant women, some women continue to use tobacco products. […] The U.S. Preventive Services Task Force has concluded that current evidence is insufficient to assess the balance of benefits and harms of nicotine replacement products or other pharmaceuticals for tobacco cessation during pregnancy. […] Obstetrician-gynecologists and other obstetric care professionals should counsel women about the risks of smoking and the benefits of cessation and discuss the resources available to help with smoking cessation, which may include the use of varenicline and bupropion.

• #50 Tobacco and Nicotine Cessation During Pregnancy | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/05/tobacco-and-nicotine-cessation-during-pregnancy

  Counseling, financial incentives, and feedback-based interventions such as cognitive behavioral therapy are associated with a reduction in smoking during pregnancy and decreased risk for infants with low birth weight. […] Women who indicate that they are not ready to quit smoking can benefit from consistent motivational approaches provided by their health care professionals. […] Clinicians should individualize care by offering psychosocial, behavioral, and pharmacotherapy interventions. […] Although counseling and pregnancy-specific materials are effective cessation aids for many pregnant women, some women continue to use tobacco products. […] The U.S. Preventive Services Task Force has concluded that current evidence is insufficient to assess the balance of benefits and harms of nicotine replacement products or other pharmaceuticals for tobacco cessation during pregnancy. […] Obstetrician-gynecologists and other obstetric care professionals should counsel women about the risks of smoking and the benefits of cessation and discuss the resources available to help with smoking cessation, which may include the use of varenicline and bupropion.

• #51

  https://www.tobaccopreventioncessation.com/Good-Practice-Statements-for-the-treatment-of-nicotine-dependence,167964,0,2.html

  GPS 4. It is reasonable to consider nicotine replacement therapy (NRT) with counselling in youth or pregnant women unable to quit with counselling alone. […] GPS 5. It is reasonable to use a digital intervention (via applications on mobile phones, text messages, online programs). […] In conclusion, there is a pressing need for the development of GPS in healthcare practice to address nicotine dependence in individuals using non-conventional tobacco and nicotine products. These GPS should be supported by a clear and explicit rationale that connects the available indirect evidence. However, it is essential to conduct large-scale studies involving users of these products to obtain robust evidence on the appropriate and effective treatment approaches. […] Currently, it is crucial to provide treatment indications in the form of GPS for all individuals addicted to these new and emerging products who are motivated to quit. These GPS are not only sustainable but also based on treatment approaches that have already demonstrated effectiveness in smoking cessation. Implementing these GPS can have positive consequences for public health, as they offer viable solutions for nicotine addiction in this specific population.

• #52 Management of smoking and vaping cessation in adolescents – UpToDate

  https://www.uptodate.com/contents/management-of-smoking-and-vaping-cessation-in-adolescents

  INTRODUCTION […] Tobacco and nicotine use by smoking or vaping (via electronic cigarettes [e-cigarettes] and other devices) often starts during adolescence but can have important health effects throughout life. Intervention to support cessation among adolescents who smoke or vape is particularly important because this may reduce or prevent nicotine dependence and avoid progression to chronic smoking. […] […] […] Smoking in adulthood is strongly associated with smoking during adolescence: 90 percent of adult smokers smoked their first cigarette before the age of 18. Further, over one-half of young adults who smoke daily started at age 6 to 12 years. This strong tracking of smoking from youth to adulthood may be attributable at least in part to nicotine dependence, since youth are particularly vulnerable to becoming dependent on nicotine compared with adults.

• #53 Management of smoking and vaping cessation in adolescents – UpToDate

  https://www.uptodate.com/contents/management-of-smoking-and-vaping-cessation-in-adolescents

  INTRODUCTION […] Tobacco and nicotine use by smoking or vaping (via electronic cigarettes [e-cigarettes] and other devices) often starts during adolescence but can have important health effects throughout life. Intervention to support cessation among adolescents who smoke or vape is particularly important because this may reduce or prevent nicotine dependence and avoid progression to chronic smoking. […] […] […] Smoking in adulthood is strongly associated with smoking during adolescence: 90 percent of adult smokers smoked their first cigarette before the age of 18. Further, over one-half of young adults who smoke daily started at age 6 to 12 years. This strong tracking of smoking from youth to adulthood may be attributable at least in part to nicotine dependence, since youth are particularly vulnerable to becoming dependent on nicotine compared with adults.

• #54 Nicotine Replacement Therapy and Adolescent Patients

  https://www.aap.org/en/patient-care/tobacco-control-and-prevention/youth-tobacco-cessation/nicotine-replacement-therapy-and-adolescent-patients/?srsltid=AfmBOop5FGlDHv2VquLmhLAJXNCjXEVhwelK_iFu2OZzvRfUxzTtv7XJ

  Nicotine Replacement Therapy (NRT) can be an important tool for treating nicotine dependence in youth. […] This combination therapy allows the patient to keep a steady level of nicotine in their bloodstream throughout the day, while also responding to cravings. […] NRT works best when paired with behavioral counseling interventions. […] Given the effectiveness of NRT for adults and the severe harms of tobacco dependence, AAP policy recommends that pediatricians consider off-label NRT for youth who are moderately or severely addicted to nicotine and motivated to quit. […] Non-adherence and relapse after cessation of therapy is common, and close follow-up is recommended. […] Pediatricians and other health care providers should inform patients of the benefits and drawbacks of the five NRT medications, screen for relative contraindications, and instruct patients in how to use the product appropriately.

• #55 Nicotine Replacement Therapy and Adolescent Patients

  https://www.aap.org/en/patient-care/tobacco-control-and-prevention/youth-tobacco-cessation/nicotine-replacement-therapy-and-adolescent-patients/?srsltid=AfmBOop5FGlDHv2VquLmhLAJXNCjXEVhwelK_iFu2OZzvRfUxzTtv7XJ

  Nicotine Replacement Therapy (NRT) can be an important tool for treating nicotine dependence in youth. […] This combination therapy allows the patient to keep a steady level of nicotine in their bloodstream throughout the day, while also responding to cravings. […] NRT works best when paired with behavioral counseling interventions. […] Given the effectiveness of NRT for adults and the severe harms of tobacco dependence, AAP policy recommends that pediatricians consider off-label NRT for youth who are moderately or severely addicted to nicotine and motivated to quit. […] Non-adherence and relapse after cessation of therapy is common, and close follow-up is recommended. […] Pediatricians and other health care providers should inform patients of the benefits and drawbacks of the five NRT medications, screen for relative contraindications, and instruct patients in how to use the product appropriately.

• #56 Nicotine Replacement Therapy and Adolescent Patients

  https://www.aap.org/en/patient-care/tobacco-control-and-prevention/youth-tobacco-cessation/nicotine-replacement-therapy-and-adolescent-patients/?srsltid=AfmBOop5FGlDHv2VquLmhLAJXNCjXEVhwelK_iFu2OZzvRfUxzTtv7XJ

  For best results, patients should be advised to pair a long-acting form of NRT (eg, nicotine patch) with a shorter-acting form (eg, gum, lozenge, spray, or inhaler). […] Patients who are motivated to quit should use as much safe, FDA-approved NRT as needed to avoid smoking or vaping. […] Pediatricians and other healthcare providers should work with each patient to determine a starting dosage of NRT that is most likely to help them quit successfully. […] Pediatrician and patients should work together to wean NRT over time, when the patient feels that s/he is no longer at risk of returning to tobacco or nicotine use.

• #57 Nicotine Addiction Treatment & Management: Approach Considerations, Counseling, Nicotine Replacement Therapy

  https://emedicine.medscape.com/article/287555-treatment

  Tobacco use is the greatest potentially remedial problem throughout the world, and it is the number one preventable cause of death in the developed world. Clinicians have a particularly important role as patient advocates in health promotion, discouraging smoking initiation, encouraging and assisting smoking patients to quit, and participating in social efforts designed to curb smoking at various levels. […] A critical component of cessation treatment is educating patients about the benefits of smoking cessation and the cessation process. Describe the expected withdrawal syndrome. Continue with a discussion of the possible cessation methods, which include counseling, NRT, bupropion, varenicline, behavioral training, group therapy, and quitting cold turkey. Successful cessation is confirmed by self-reporting, which can be validated by measuring cotinine or carbon monoxide levels.

• #58 Nicotine Addiction Treatment & Management: Approach Considerations, Counseling, Nicotine Replacement Therapy

  https://emedicine.medscape.com/article/287555-treatment

  More than 90% of patients who attempt to quit smoking stop cold turkey. Professional group therapy or counseling achieves an initial cessation rate of 60100% and a one-year cessation rate of approximately 20%. […] Patients who quit smoking tend to gain weight; therefore, patients should be encouraged to follow a low-calorie diet and exercise regimen during and after cessation. In patients attempting smoking cessation, exercise has been shown to help curb long-term weight gain and to help alleviate nicotine withdrawal symptoms. […] Smoking may begin as a voluntary habit, but eventually it becomes an addiction. Health professionals can contribute powerfully to motivating their patients to attempt and sustain cessation by offering encouragement, advice, and assistance. […] According to US Preventive Services Task Force (USPSTF) guidelines, clinicians should ask all adults about use of tobacco products and should provide cessation interventions to all current tobacco users.

• #59 Nicotine Addiction Treatment & Management: Approach Considerations, Counseling, Nicotine Replacement Therapy

  https://emedicine.medscape.com/article/287555-treatment

  More than 90% of patients who attempt to quit smoking stop cold turkey. Professional group therapy or counseling achieves an initial cessation rate of 60100% and a one-year cessation rate of approximately 20%. […] Patients who quit smoking tend to gain weight; therefore, patients should be encouraged to follow a low-calorie diet and exercise regimen during and after cessation. In patients attempting smoking cessation, exercise has been shown to help curb long-term weight gain and to help alleviate nicotine withdrawal symptoms. […] Smoking may begin as a voluntary habit, but eventually it becomes an addiction. Health professionals can contribute powerfully to motivating their patients to attempt and sustain cessation by offering encouragement, advice, and assistance. […] According to US Preventive Services Task Force (USPSTF) guidelines, clinicians should ask all adults about use of tobacco products and should provide cessation interventions to all current tobacco users.

• #60 Nicotine Addiction Treatment & Management: Approach Considerations, Counseling, Nicotine Replacement Therapy

  https://emedicine.medscape.com/article/287555-treatment

  Brief behavioral counseling (ie, 10 minutes) and pharmacotherapy are each effective when used alone, though they are most effective when used together. […] Nicotine replacement therapy (NRT) works by making it easier to abstain from tobacco by partially replacing the nicotine previously obtained from tobacco. […] Nicotine replacement medications should not be viewed as standalone medications that make people stop smoking; reassurance and guidance from health professionals are still critical for helping patients achieve and sustain abstinence. […] In a Cochrane meta-analysis of 132 trials involving the use of any type of NRT along with a placebo or non-NRT control group, the risk ratio (RR) of abstinence for any form of NRT relative to control was 1.58. […] Thus, all of the commercially available forms of NRT increase the chances of successful smoking cessation. Overall, NRT increases the quit rate by 5070%, and the increase appears to be independent of any additional support provided.

• #61 Nicotine Addiction Treatment & Management: Approach Considerations, Counseling, Nicotine Replacement Therapy

  https://emedicine.medscape.com/article/287555-treatment

  Bupropion acts by alleviating some of the symptoms of nicotine withdrawal, which include depression. […] Compared with placebo, bupropion approximately doubles smoking cessation rates, and it is equally effective for men and women. […] Varenicline helps smokers quit by preventing withdrawal symptoms while moderate levels of dopamine are maintained in the brain. […] The main adverse effect of varenicline was nausea, which was mostly mild to moderate and usually subsided over time. […] Highly nicotine-dependent smokers may require initial therapy for 6 months or longer. Some individuals may require low-dose maintenance therapy for years. […] Long-term follow-up is recommended because individuals who successfully quit smoking are at high risk for relapse.

• #62 Tobacco Use: The Current State of Affairs and How Nurses Can Help Patients Quit | OJIN: The Online Journal of Issues in Nursing

  https://ojin.nursingworld.org/table-of-contents/volume-25-2020/number-3-september-2020/tobacco-use-the-current-state-of-affairs-and-how-nurses-can-help-patients-quit/

  Tobacco related illnesses may be avoided by preventing the initiation of ever smoking, and early intervention in the successful cessation of tobacco products. […] Nursing, represented by 4 million highly capable professionals practicing across the care continuum, constitutes critical resources toward this effort. […] Nicotine is one of the most addictive known substances. […] The symptomatic swings in nicotine blood concentration directly correlate with regular use and daily dosing of nicotine and the intolerability of nicotine withdrawal symptoms, which often lead to the resumption of nicotine use or relapse. […] Tobacco (nicotine) dependence is a chronic relapsing condition. […] Successful cessation is a process; nurses and other healthcare professionals must not give up on patients in the cessation journey.

• #63 Clinical Interventions to Treat Tobacco Use and Dependence Among Adults | Smoking and Tobacco Use | CDC

  https://www.cdc.gov/tobacco/hcp/patient-care-settings/clinical.html

  Remind patients that it is never too late to quit smoking. Quitting is beneficial at any age. For pregnant patients, remind them, although smoking cessation at any point during pregnancy yields health benefits, quitting early in pregnancy provides the greatest benefit to mother and baby. […] Offer patients a combination of counseling and medications. […] Refer patients to cessation resources and programs in your health system and community. You can also refer them to telephone quitlines (1-800-QUIT-NOW) and text messaging (e.g., SmokefreeTXT) and web-based interventions (e.g., cdc.gov/quit and smokfree.gov). […] Assess your patients’ progress over time and provide additional support. It may take several attempts for them to quit smoking. […] Provide ongoing support and encourage patients to keep trying and not give up.

• #64 Managing nicotine dependence in NSW hospitals under the Smoke-free Health Care Policy «

  https://www.phrp.com.au/issues/july-2015-volume-25-issue-3/managing-nicotine-dependence-in-nsw-hospitals-under-the-smoke-free-health-care-policy/

  Under the new NSW Health Smoke-free Health Care Policy, the smoke-free status of public hospital campuses has been reaffirmed and all clinical staff are required to provide routine brief interventions for all smoking patients. […] Counselling beginning in hospital and continuing for at least 1 month after discharge significantly increases quit rates. […] Nicotine replacement therapy (NRT) should be offered to all nicotine-dependent smokers soon after admission. NRT helps manage cravings and nicotine withdrawal symptoms and significantly increases quit rates. […] Smoking cessation support is the responsibility of all medical, nursing and allied health staff. […] Smoking can be addressed using the 5As model: ask, assess, advise, assist and arrange follow-up. […] Follow-up for at least 1 month after discharge is an essential ingredient for long-term success and should be arranged before discharge.

• #65 Nicotine dependence – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nicotine-dependence/diagnosis-treatment/drc-20351590

  Many hospitals, health care plans, health care providers and employers offer treatment programs. Some medical centers provide residential treatment programs the most intensive treatment available. […] Social support is key to achieving a stable and solid, smoke-free life. Ask your family, friends and co-workers for support and encouragement. […] Support groups offer coaching and mutual support from others attempting to quit. Nicotine Anonymous groups are available in many locations. […] Quit lines offer convenient access to trained counselors. […] To get ready for your appointment: Consider your smoking triggers. […] Make note of any symptoms that may be related to smoking. […] Make a list of your medications. […] Being ready to answer questions your doctor may ask reserves time to go over any points you want to spend more time on.

• #66 Smoking: Nursing Diagnoses & Care Plans | NurseTogether

  https://www.nursetogether.com/smoking-nursing-diagnosis-care-plan/

  Patients who are addicted to smoking and nicotine will find it difficult to modify their lifestyle and unhealthy behaviors even if they are aware that these behaviors are putting their health at risk. […] The patient will verbalize acceptance of health status changes and the need to quit smoking. […] Smoking is addictive and without an established goal to change this unhealthy behavior, smoking cessation cannot be achieved. […] Many states have tobacco quit programs that provide free counseling, resources, and medications to quit smoking.

• #67 Nicotine dependence – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nicotine-dependence/diagnosis-treatment/drc-20351590

  Many hospitals, health care plans, health care providers and employers offer treatment programs. Some medical centers provide residential treatment programs the most intensive treatment available. […] Social support is key to achieving a stable and solid, smoke-free life. Ask your family, friends and co-workers for support and encouragement. […] Support groups offer coaching and mutual support from others attempting to quit. Nicotine Anonymous groups are available in many locations. […] Quit lines offer convenient access to trained counselors. […] To get ready for your appointment: Consider your smoking triggers. […] Make note of any symptoms that may be related to smoking. […] Make a list of your medications. […] Being ready to answer questions your doctor may ask reserves time to go over any points you want to spend more time on.

• #68 Smoking: Nursing Diagnoses & Care Plans | NurseTogether

  https://www.nursetogether.com/smoking-nursing-diagnosis-care-plan/

  Patients who are addicted to smoking and nicotine will find it difficult to modify their lifestyle and unhealthy behaviors even if they are aware that these behaviors are putting their health at risk. […] The patient will verbalize acceptance of health status changes and the need to quit smoking. […] Smoking is addictive and without an established goal to change this unhealthy behavior, smoking cessation cannot be achieved. […] Many states have tobacco quit programs that provide free counseling, resources, and medications to quit smoking.

• #69 Nicotine dependence – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nicotine-dependence/diagnosis-treatment/drc-20351590

  Many hospitals, health care plans, health care providers and employers offer treatment programs. Some medical centers provide residential treatment programs the most intensive treatment available. […] Social support is key to achieving a stable and solid, smoke-free life. Ask your family, friends and co-workers for support and encouragement. […] Support groups offer coaching and mutual support from others attempting to quit. Nicotine Anonymous groups are available in many locations. […] Quit lines offer convenient access to trained counselors. […] To get ready for your appointment: Consider your smoking triggers. […] Make note of any symptoms that may be related to smoking. […] Make a list of your medications. […] Being ready to answer questions your doctor may ask reserves time to go over any points you want to spend more time on.

• #70 APNA Nursing Competencies for Treating Tobacco Use Disorders | APNA

  https://www.apna.org/resources/apna-nursing-competencies-for-treating-tobacco-use-disorders/

  The PMH-RN and PMH-APRN: Understands the effects of nicotine and tobacco use on specific populations and the treatment needs for patients in a variety of clinical settings. […] The PMH-RN and PMH-APRN: Performs an evidence-based comprehensive tobacco and nicotine dependency assessment for the basis of applying diagnostic criteria. […] The PMH-APRN and RN: Applies existing and emerging evidence-based pharmacotherapies for treating nicotine dependency to prevent physical and mental health problems associated with tobacco use and dependency. […] The PMH-RN and PMH-APRN: Engages relevant multidisciplinary team members to strategize evidence-based care coordination. […] The PMH-RN and PMH-APRN: Combines evidence-based counseling and psychotherapies with FDA-approved tobacco treatment medications to achieve the best practice gold standard treatment.

• #71 Treating tobacco dependence: guidance for primary care on life-saving interventions. Position statement of the IPCRG | npj Primary Care Respiratory Medicine

  https://www.nature.com/articles/s41533-017-0039-5

  Tobacco dependence is a deadly epidemic killing up to half its users. […] Tobacco use is the leading cause of premature death globally due to the many diseases, which are attributed wholly or partially to smoking resulting in nearly six million deaths a year. […] Tobacco dependence is recognised by WHO as a chronic relapsing condition that normally begins in childhood or adolescence. […] Clinicians should apply the same principles to tobacco dependence as to other chronic relapsing conditions. This includes offering patients accurate and timely diagnosis, evidence-based treatment that aims to co-produce outcomes with the patient using behavioural and pharmacological support, and regular review, anticipating the likelihood of relapse and, therefore, offering a system for repeated support to quit.

• #72 APNA Position: Psychiatric-Mental Health Nursing’s Role in Tobacco Treatment | APNA

  https://www.apna.org/news/psychiatric-mental-health-nursings-role-in-tobacco-treatment/

  Psychiatric-Mental Health Nurses are Champions in Translating Evidence into Effective Tobacco Treatment for Every Patient, at Every Visit, in Every Setting. […] For example, nurses now have more options to become informed and trained in evidence-based tobacco treatment interventions. […] Because psychiatric-mental health nurses are leaders in translating evidence into effective tobacco treatment, and because tobacco use disorders should receive care in every clinical setting, the APNA formed a task force to develop Nursing Competencies for Treating Tobacco Use and Dependence. […] The American Psychiatric Nurses Association understands that tobacco use and dependence is an addiction and patients with tobacco use disorders should receive care in every clinical setting. […] APNA also recognizes that many challenges remain in providing nursing education on effective nursing tobacco treatment and that the Nursing Competencies for Treating Tobacco Use and Dependence are a first step towards addressing that issue.

• #73 APNA Position: Psychiatric-Mental Health Nursing’s Role in Tobacco Treatment | APNA

  https://www.apna.org/news/psychiatric-mental-health-nursings-role-in-tobacco-treatment/

  Psychiatric-Mental Health Nurses are Champions in Translating Evidence into Effective Tobacco Treatment for Every Patient, at Every Visit, in Every Setting. […] For example, nurses now have more options to become informed and trained in evidence-based tobacco treatment interventions. […] Because psychiatric-mental health nurses are leaders in translating evidence into effective tobacco treatment, and because tobacco use disorders should receive care in every clinical setting, the APNA formed a task force to develop Nursing Competencies for Treating Tobacco Use and Dependence. […] The American Psychiatric Nurses Association understands that tobacco use and dependence is an addiction and patients with tobacco use disorders should receive care in every clinical setting. […] APNA also recognizes that many challenges remain in providing nursing education on effective nursing tobacco treatment and that the Nursing Competencies for Treating Tobacco Use and Dependence are a first step towards addressing that issue.

• #74 APNA Position: Psychiatric-Mental Health Nursing’s Role in Tobacco Treatment | APNA

  https://www.apna.org/news/psychiatric-mental-health-nursings-role-in-tobacco-treatment/

  Therefore, the American Psychiatric Nurses Association takes the position that Psychiatric Mental Health Nurses are Champions in the Translation of Evidence into Effective Tobacco Treatment for Every Patient, at Every Visit, in Every Setting. […] Positioning of psychiatric-mental health nurses as leaders, champions, and subject matter experts who disseminate efficacious tobacco treatment evidence. […] Empowering nurses to advocate for patients and participate in the development and implementation of multidisciplinary local, state, and national tobacco treatment policy and guidelines.

• #75 APNA Nursing Competencies for Treating Tobacco Use Disorders | APNA

  https://www.apna.org/resources/apna-nursing-competencies-for-treating-tobacco-use-disorders/

  All patients with TUD would benefit from accessible, effective care whether they have been diagnosed with a mental health condition or not. […] Therefore, all nurses would benefit from foundational competency in providing TUD care. […] The psychiatric-mental health nursing scope of practice specifically encompasses the treatment of all substance use, including tobacco use, and thus uniquely places psychiatric nurses to demonstrate leadership in role modeling, teaching evidence-based TUD treatment, and engaging in innovative TUD treatment strategies. […] The tobacco competencies are written with the PMH RN and APRN in mind but can be adapted by nurses of all specialties. […] The PMH-RN and PMH-APRN: Engages in self-reflection activities to expand the therapeutic use of self in treating tobacco and nicotine dependence.

• #76 APNA Nursing Competencies for Treating Tobacco Use Disorders | APNA

  https://www.apna.org/resources/apna-nursing-competencies-for-treating-tobacco-use-disorders/

  The PMH-RN and PMH-APRN: Understands the effects of nicotine and tobacco use on specific populations and the treatment needs for patients in a variety of clinical settings. […] The PMH-RN and PMH-APRN: Performs an evidence-based comprehensive tobacco and nicotine dependency assessment for the basis of applying diagnostic criteria. […] The PMH-APRN and RN: Applies existing and emerging evidence-based pharmacotherapies for treating nicotine dependency to prevent physical and mental health problems associated with tobacco use and dependency. […] The PMH-RN and PMH-APRN: Engages relevant multidisciplinary team members to strategize evidence-based care coordination. […] The PMH-RN and PMH-APRN: Combines evidence-based counseling and psychotherapies with FDA-approved tobacco treatment medications to achieve the best practice gold standard treatment.

• #77 APNA Nursing Competencies for Treating Tobacco Use Disorders | APNA

  https://www.apna.org/resources/apna-nursing-competencies-for-treating-tobacco-use-disorders/

  The PMH-RN and PMH-APRN: Analyzes current tobacco and nicotine policies, regulations, and clinical practice guidelines to address health disparities in TUD treatment. […] The PMH-RN and PMH-APRN: Engages in scientific inquiry to effectively synthesize tobacco and nicotine dependency treatment evidence into clinical practice, and local, state, and national tobacco treatment policies. […] The PMH-RN and PMH-APRN: Utilizes systems change processes and evidence-based practice to engage in or lead in the development, implementation, and evaluation of tobacco and nicotine dependence programs.

• #78 What are treatments for tobacco dependence? | National Institute on Drug Abuse (NIDA)

  https://nida.nih.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/what-are-treatments-tobacco-dependence

  Research also suggests that this medication may be more effective than bupropion. […] Some studies suggest that combining NRT with other medications may facilitate cessation. […] Researchers have been examining ways to personalize treatment based on important individual biological differences, including genetic differences. […] A recent study compared rates of abstinence 1 week after treatment for slow, normal, and fast metabolizers of nicotine who were randomly assigned to either placebo, NRT, or varenicline. […] NIDA supports research to develop new and improve current treatment options for smoking cessation based on a growing understanding of the neurobiology of addiction. […] Another approach that could prevent relapse and that has shown promise in early studies is a nicotine vaccine, which would generate antibodies that keep nicotine from reaching the brain.

• #79 What are treatments for tobacco dependence? | National Institute on Drug Abuse (NIDA)

  https://nida.nih.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/what-are-treatments-tobacco-dependence

  Research also suggests that this medication may be more effective than bupropion. […] Some studies suggest that combining NRT with other medications may facilitate cessation. […] Researchers have been examining ways to personalize treatment based on important individual biological differences, including genetic differences. […] A recent study compared rates of abstinence 1 week after treatment for slow, normal, and fast metabolizers of nicotine who were randomly assigned to either placebo, NRT, or varenicline. […] NIDA supports research to develop new and improve current treatment options for smoking cessation based on a growing understanding of the neurobiology of addiction. […] Another approach that could prevent relapse and that has shown promise in early studies is a nicotine vaccine, which would generate antibodies that keep nicotine from reaching the brain.

• #80 What are treatments for tobacco dependence? | National Institute on Drug Abuse (NIDA)

  https://nida.nih.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/what-are-treatments-tobacco-dependence

  Research also suggests that this medication may be more effective than bupropion. […] Some studies suggest that combining NRT with other medications may facilitate cessation. […] Researchers have been examining ways to personalize treatment based on important individual biological differences, including genetic differences. […] A recent study compared rates of abstinence 1 week after treatment for slow, normal, and fast metabolizers of nicotine who were randomly assigned to either placebo, NRT, or varenicline. […] NIDA supports research to develop new and improve current treatment options for smoking cessation based on a growing understanding of the neurobiology of addiction. […] Another approach that could prevent relapse and that has shown promise in early studies is a nicotine vaccine, which would generate antibodies that keep nicotine from reaching the brain.

• #81 Nursing Diagnosis for Substance Abuse: 8 Care Plans – Nurseslabs

  https://nurseslabs.com/substance-abuse-nursing-diagnosis-care-plan/

  Denial can be replaced with positive action when the client accepts the reality of their own responsibility. […] Telemedicine and online digital recovery support services (D-RSS) have taken center stage as potential solutions for individuals who are increasingly unable to access SUD treatment and recovery support services in person. […] These medications are often used as part of a comprehensive treatment approach that includes counseling, behavioral therapies, and social support to help in recovery.

• #82

  https://www.tobaccopreventioncessation.com/Good-Practice-Statements-for-the-treatment-of-nicotine-dependence,167964,0,2.html

  Nicotine dependence is increasing worldwide due to a wide variety of new and emerging products (e.g. heated tobacco products, electronic cigarettes, nicotine pouches, novel herbal products) with tobacco and/or nicotine content, being continuously placed on the market, including online stores. […] The current and potential future scenario regarding consumers of new and emerging tobacco and nicotine products and their sustained addiction to nicotine is a significant global public health concern. To address this issue, it is crucial to incorporate individuals addicted to these products into the existing treatments for smoking cessation, as per the Good Practice Statements (GPS) provided by the GRADE working group. […] In situations where studies do not include users of various tobacco and nicotine products like electronic cigarettes, heated tobacco products, or other emerging products containing tobacco and/or nicotine with addictive potential, it may be necessary to develop GPS to address nicotine dependence. The interventions recommended in these GPS are based on existing evidence-based interventions for smoking cessation, including pharmacotherapy, counselling, and digital interventions.

• #83

  https://www.tobaccopreventioncessation.com/Good-Practice-Statements-for-the-treatment-of-nicotine-dependence,167964,0,2.html

  For consumers of heated tobacco products, smokeless tobacco and nicotine-containing products (e.g. electronic cigarettes, nicotine pouches or any other new and emerging nicotine product with an addictive potential), the proposed GPS are the following: GPS 1. It is reasonable to give brief advice for cessation. Brief cessation advice should consist of asking about the details of product use [type(s) of product(s), frequency of use, nicotine content, and duration of use], advising to quit, and assessing readiness to quit. […] GPS 2. It is reasonable to offer pharmacotherapy to treat nicotine withdrawal symptoms. Pharmacotherapy includes the use of nicotine replacement therapy (NRT) in its different formulations and/or combinations (slow release and rapid release), as well as varenicline. […] GPS 3. It is reasonable to offer individual or group counselling combined with pharmacotherapy. The choice of pharmacotherapy depends on clinical considerations and patient preferences.

• #84

  https://www.tobaccopreventioncessation.com/Good-Practice-Statements-for-the-treatment-of-nicotine-dependence,167964,0,2.html

  GPS 4. It is reasonable to consider nicotine replacement therapy (NRT) with counselling in youth or pregnant women unable to quit with counselling alone. […] GPS 5. It is reasonable to use a digital intervention (via applications on mobile phones, text messages, online programs). […] In conclusion, there is a pressing need for the development of GPS in healthcare practice to address nicotine dependence in individuals using non-conventional tobacco and nicotine products. These GPS should be supported by a clear and explicit rationale that connects the available indirect evidence. However, it is essential to conduct large-scale studies involving users of these products to obtain robust evidence on the appropriate and effective treatment approaches. […] Currently, it is crucial to provide treatment indications in the form of GPS for all individuals addicted to these new and emerging products who are motivated to quit. These GPS are not only sustainable but also based on treatment approaches that have already demonstrated effectiveness in smoking cessation. Implementing these GPS can have positive consequences for public health, as they offer viable solutions for nicotine addiction in this specific population.

• #85 Clinical Interventions to Treat Tobacco Use and Dependence Among Adults | Smoking and Tobacco Use | CDC

  https://www.cdc.gov/tobacco/hcp/patient-care-settings/clinical.html

  Tobacco use and dependence is a chronic, relapsing condition that often requires repeated intervention and long-term support. Quitting can be hard, but evidence-based treatments improve success. Below are clinical interventions that work to help adult patients quit smoking. […] Counseling can be in person (one-on-one or in a group) or over a telephone quitline. […] Text messaging (e.g., SmokefreeTXT) and web-based interventions (e.g., cdc.gov/quit and smokfree.gov) also help people quit smoking. […] Seven medications are approved by the U.S. Food and Drug Administration (FDA) for smoking cessation. […] Nicotine Replacement Therapy (NRT) reduces nicotine withdrawal symptoms and is available over the counter (patch, gum, and lozenge) and by prescription (inhaler and nasal spray). […] Varenicline is a nicotine receptor partial agonist available only by prescription. It reduces nicotine withdrawal symptoms (including craving) and reduces the rewarding effects of cigarettes by blocking nicotinic receptors.

• #86 Patient Care | Smoking and Tobacco Use | CDC

  https://www.cdc.gov/tobacco/hcp/patient-care/index.html

  Tobacco dependence is treatable. You can play a critical role in helping patients quit tobacco use for good. […] Tobacco dependence is a chronic, relapsing disorder. Like other chronic diseases, tobacco dependence often requires repeated intervention and long-term support. […] Health care providers in a variety of settings play a critical role in helping people quit using tobacco. Even brief advice from you can make your patients much more likely to try to quit and ultimately succeed. […] Evidence-based treatment including counseling and cessation medications approved by the U.S. Food and Drug Administration (FDA) significantly increases success in quitting tobacco. You can make a difference! […] Patient Care Settings and Smoking Cessation.

• #87

  https://journals.lww.com/10.4103/jin.jin_110_24

  Tobacco use remains one of the leading preventable causes of morbidity and mortality globally, with nicotine addiction significantly impacting health outcomes. This literature review explores the multifaceted nature of tobacco use and its health implications, emphasizing the role of nursing interventions in smoking cessation. The review highlights various strategies employed by nurses, including assessment, counseling, pharmacotherapy support, and behavioral interventions, which are essential for effective tobacco cessation. […] Nurses are uniquely positioned to play a pivotal role in tobacco control initiatives. Research demonstrates that nurse-led interventions, such as brief counseling and pharmacological treatments like nicotine replacement therapy (NRT), can significantly improve smoking cessation outcomes.

• #88 Clinical Interventions to Treat Tobacco Use and Dependence Among Adults | Smoking and Tobacco Use | CDC

  https://www.cdc.gov/tobacco/hcp/patient-care-settings/clinical.html

  Bupropion is a dopamine and norepinephrine reuptake inhibitor with nicotine receptor antagonist properties. It reduces craving and other withdrawal symptoms and is available by prescription only. […] Counseling and medication are effective on their own, but using them together can more than double the chances of quitting. […] Combining long-acting NRT (patch) with short-acting NRT (e.g., gum, lozenge) also increases the chances of quitting. […] A team approach is the best way to treat tobacco use and dependence. Integrating treatment into the routine clinical workflow and engaging the entire health care team in treatment delivery can make a difference. […] Talk to patients at every visit about their tobacco use. Even brief advice can influence a patient’s decision to quit smoking. […] Advise patients that quitting is one of the most important things they can do to improve their health and prognosis. Advise pregnant patients that quitting is one of the most important things they can do to improve their health and the health of their baby.

• #89 Using evidence-based guidelines to help patients stop smoking

  https://www.myamericannurse.com/using-evidence-based-guidelines-to-help-patients-stop-smoking/

  No matter where you work, youre likely to encounter many patients with tobacco-related illnesses, which kill at least 440,000 Americans annually. Treating tobacco use and dependence is no longer optional. Helping smokers quit is now an expected part of good nursing care. […] The American Nurses Association urges all nurses to provide tobacco-dependence treatment and to engage in other aspects of tobacco use prevention and control. […] If you care for hospitalized patients who smoke, you may observe nicotine withdrawal symptoms. If youre able to distinguish these from symptoms related to the underlying cause of hospitalization, you can develop a care plan that addresses the patients smoking-related needs. […] The first step in helping patients stop smoking is to identify and document the smoking status of all patients. For those who smoke, the PHS guideline recommends a combination of pharmacotherapy and counseling for behavior modification as the most effective strategy to help smokers quit. […] Helping patients quit smoking is one of the most important things you can do to protect a patients health. If each of the 2.9 million nurses in the United States could help four smokers quit smoking, we could reach 11.6 million smokersapproximately 25% of U.S. smokers.

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