Module Description: Tobacco use disorder is still a major cause of preventable death. Populations with low income, lower education and/or behavioral health comorbidity (mental illness or SUD) use tobacco at higher rates. Even brief interventions can be effective and should be provided routinely in health care settings. Counseling and medications are both considered first-line treatments and outcomes are better if they are provided together. Assessment of the time to first cigarette use in the morning is a good indicator of level of addiction to tobacco. Tobacco withdrawal causes clinically significant symptoms of agitation, anxiety, restlessness, and impaired concentration that can undermine success in quitting. Medications are effective in reducing these withdrawal symptoms and at least doubling the smoker’s chance of success in quitting. These medications include nicotine replacement, bupropion and varenicline. These are generally well tolerated and safer than the ongoing use of tobacco. Varenicline or combination NRT can be considered first line treatments since they are associated with greater success in quitting than other treatments. Use of medications is also associated with reductions in tobacco use that can lead to future quit attempts. This educational activity will review updates in evidence-based treatments for tobacco use disorder.
