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CHEST Guidelines
Patients-Who-Present-With-Tobacco-Use_chest
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Pdf Summary
The article by Adam Edward Lang, PharmD, discusses the importance of treating nicotine dependence as a consistent opportunity for clinical intervention rather than solely as "teachable moments" triggered by significant medical events such as ICU admissions, strokes, or lung cancer screenings. Highlighting results from a recent randomized trial by Foley et al., the text notes that integrated tobacco cessation interventions during lung cancer screenings did not significantly improve cessation rates between intervention and control groups. Moreover, only a fraction of patients were recommended treatments like nicotine replacement therapy or pharmacotherapies such as varenicline, underscoring a missed opportunity for improving smoking cessation.<br /><br />Lang argues for a cultural shift in healthcare towards providing tobacco cessation treatments universally, without waiting for patients to explicitly express an interest in quitting. He highlights that misconceptions about efficacy and safety, and inadequate training in motivational interviewing, hinder effective tobacco dependence management. The piece advocates for normalizing the recommendation of pharmacotherapies for all patients with nicotine dependence, similar to how other chronic conditions are treated, and emphasizes the need for comprehensive education in healthcare training to cultivate this cultural change.<br /><br />Overall, the article emphasizes making every medical encounter an opportunity for initiating discussions and offering treatments for nicotine dependence, aiming to improve cessation rates and health outcomes significantly. The author calls for systemic integration of these practices across healthcare settings to ensure that resources are effectively utilized and every interaction with patients who use tobacco is considered a "treatable moment."
Keywords
nicotine dependence
clinical intervention
smoking cessation
tobacco cessation
pharmacotherapies
motivational interviewing
healthcare training
cultural shift
medical encounters
treatable moments
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