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Preventing Tobacco Use and Related Diseases in Adults and Pregnant Women: U.S. Preventive Services Task Force Reaffirmation Recommendation Statement
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Who developed these recommendations?
The U.S. Preventive Services Task Force (USPSTF) is a group of health experts that makes recommendations about preventive health care.
What is the problem and what is known about it so far?
Smoking increases risks for several diseases, including heart disease, lung disease, and some types of cancer. Smoking also increases the risk for bad outcomes of pregnancy, including miscarriage, low birthweight, and early delivery. Quitting smoking can be very difficult. Helping patients to stop smoking is an important activity for physicians. This process begins with counseling, a skill that requires the ability to evaluate the patient's readiness to quit and to motivate patients into effective action. For some patients, nicotine replacement and other drugs can help them quit. In 2003, the USPSTF concluded that the benefits of smoking cessation interventions by primary care settings outweighed their risks. The USPSTF wanted to see if new studies would change its recommendations.
How did the USPSTF develop these recommendations?
The USPSTF reviewed published research since 2003 on the benefits and harms of counseling and other strategies during primary care visits to reduce tobacco use in pregnant and nonpregnant adults.
What did the authors find?
The USPSTF found convincing evidence that smoking cessation interventions delivered in primary care settings for nonpregnant adults increase the proportion of smokers who successfully quit. Longer counseling is more effective than brief counseling, but even brief counseling (<3 minutes) can increase quit rates.
In pregnant women, counseling sessions that last 5 to 15 minutes and include pregnancy-focused messages work better than general interventions. The USPSTF found inadequate information about the safety of smoking cessation drugs during pregnancy.
Quitting smoking decreases a person's risk for heart disease, stroke, lung disease, and bad pregnancy outcomes.
What does the USPSTF suggest that doctors and patients do?
Doctors should ask all adult patients about smoking and help those who smoke to quit. Pregnant patients should receive counseling that includes pregnancy-focused messages.
What are the cautions related to these recommendations?
These recommendations do not apply to children and adolescents or to people who already have tobacco-related diseases.
Article and Author Information
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The summary below is from the full report titled “Counseling and Interventions to Prevent Tobacco Use and Tobacco-Caused Disease in Adults and Pregnant Women: U.S. Preventive Services Task Force Reaffirmation Recommendation Statement.” It is in the 21 April 2009 issue of Annals of Internal Medicine (volume 150, pages 551-555). The author is the U.S. Preventive Services Task Force.
