As a healthcare provider in the Federal system, you care for veterans and active-duty military personnel. You are likely aware that almost half of all military personnel smoke due in part to stress associated with deployments. In addition, veterans with posttraumatic stress disorder and/or other mental illness also smoke at higher rates. Tobacco use can lead to absenteeism, lost productivity, and increased costs to the military and the Veterans Health Administration. While all of your patients who use tobacco would benefit from tobacco cessation, patients with cardiovascular disease (CVD), diabetes, respiratory illnesses, and a number of cancers are dramatically affected by smoking. Many of your patients have been struggling to quit and may have tried unsuccessfully, sometimes a number of times. You know that tobacco use is a major risk factor for CV morbidity and mortality and can exacerbate a number of other conditions. Even a low smoking burden can increase risk. Indeed, tobacco use:
- Exacerbates atherogenesis and thrombosis formation
- Increases risk of heart disease, acute coronary events, and CVD-related complications
- Makes glycemic control in diabetics more difficult; increases diabetes-related complications
- Worsens respiratory illnesses
- Contributes to lung cancer, as well as a number of other cancers
Your patients need to quit, and they need your help to do so. The key to is to recognize tobacco use as an addiction. Patients need counseling and guidance, referral to treatment centers or other forms of assistance, and pharmacologic intervention to achieve success in quitting. As a primary care provider, you face unique challenges when trying to get your patients to quit. It can be discouraging to see patients continue to smoke or relapse following a quit attempt. Becomingfamiliar with the guidelines, learning which cessation treatments work, offering compassionate and persistent counseling, and working with colleagues as a multidisciplinary team can help your patients quit for good.
This supplement provides a review of current guideline recommendations for tobacco cessation, particularly in high-risk populations. It offers guidance, best practices, and tools to assist you in helping your patients who often have a number of comorbidities, to quit using tobacco products. By reviewing recent clinical trial data, the supplement highlights current smoking cessation therapies that can be incorporated into a comprehensive, individualized treatment plan. Finally, the supplement addresses e-cigarettes, recent controversies related to their use, the current e-cigarette health crisis, and their use in smoking cessation. As a primary care provider, you have a unique opportunity to help your patients stop using tobacco and work collaboratively with you to take control of their lives.
Instructions for Receiving Credit
Participants should read the activity information, review the activity in its entirety, and complete the online post-test and evaluation. Upon completing this activity as designed and achieving a passing score of 70% on the posttest, you will be directed to a Web page that will allow you to receive your certificate of credit via email or you may print it out at that time. The online post-test and evaluation can be accessed at https://tinyurl.com/smoking-cessation-supp
Michael J. Blaha, MD, MPH
Professor of Medicine and Epidemiology
Director of Clinical Research
Johns Hopkins Ciccarone Center for the Prevention
of Cardiovascular Disease
Adam O. Goldstein, MD, MPH
Professor, UNC Family Medicine
UNC School of Medicine
Director, UNC Tobacco Intervention Programs
Chapel Hill, NC
Thomas J. Payne, PhD, NCTTP
Professor of Otolaryngology and Director of ACT Center
University of Mississippi Medical Center
This activity has been designed to address the educational needs of clinicians involved in management of patients who smoke, including cardiologists, endocrinologists,
internal medicine and family medicine physicians, clinicians working in the Federal health system, physician assistants (PAs), nurse practitioners (NPs), and nurses.
At the conclusion of this activity, participants should be better able to:
- Demonstrate an understanding of current guideline recommendations for smoking cessation in high-risk populations
- Identify an appropriate action plan for patients who use tobacco and have comorbid conditions
- Review current clinical trial data demonstrating the safety and efficacy of US Food and Drug Administration (FDA)-approved smoking cessation therapies to better individualize therapy for patients who use tobacco
- Discuss recent controversies regarding the use of e-cigarettes in smoking cessation
Statement of Educational Need
Tobacco is the leading preventable cause of disease, disability, and death in the US. Both combustible forms and e-cigarettes (“vaping”) pose a public health challenge,
especially among younger people. In this timely review, experts assess the evidence for use of drug and nicotinereplacement treatments and debunk the myth that vaping
is an effective strategy for tobacco cessation. The authors provide practical strategies for implementing tobacco cessation plans in various clinical settings to improve
Clinicians need to improve their understanding of recommendations and strategies, as well as recent clinical evidence related to FDA-approved therapies, to make
informed treatment decisions that more effectively help their patients reduce or eliminate their use of tobacco and nicotine-containing products.
Conflict of Interest Policy/ Disclosure Statement
Global Education Group (Global) requires instructors, planners, managers and other individuals and their spouse/life partner who are in a position to control the content of this
activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted
by Global for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.
Disclosure of Conflicts of Interest
Global Education Group (Global) requires instructors, planners, managers, and other individuals and their spouse/life partner who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by Global for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.
The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the
content of this CME activity:
Michael J. Blaha, MD, MPH, Investigator: Aetna, Amgen. Honoraria: Amgen, Bayer, Novartis, Novo Nordisk, Sanofi Regeneron.
Adam O. Goldstein, MD, has nothing to disclose.
Thomas J. Payne, PhD, NCTTP, has nothing to disclose.
Planners/Managers: The Global Education Group planners and managers have nothing to disclose. The Global Academy for Medical Education planners and managers have nothing to disclose.
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Global Education Group (Global) and Global Academy for Medical Education. Global is accredited by the ACCME to provide continuing medical education for physicians.
Physician Credit Designation
Global Education Group designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credits™.Physicians should claim only the credit commensurate with
the extent of their participation in the activity.
Nurse Credit Designation
Global Education Group is accredited with distinction as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.
This educational activity for 1.0 contact hour is provided by Global Education Group. Nurses should claim only the credit commensurate with the extent of their participation in the activity.
There is no fee for this educational activity.
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Global Education Group (Global) and Global Academy for Medical Education do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed in this activity should not be used by clinicians without evaluation of patient conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Questions About the Activity
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Computer System Requirements
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Google Chrome 28.0+ for Windows, Mac OS, or Linux
Mozilla Firefox 23.0+ for Windows, Mac OS, or Linux
Supported Phones & Tablets:
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iPhone/iPad with iOS 6.1 or above.