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Smoking Cessation For the Busy Clinician

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More than 50 years after the landmark 1964 Surgeon General’s Report on the health consequences of smoking, an estimated 15% of adult Americans still smoke. Smoking remains the leading cause of preventable death in the United States – accounting for 480,000 deaths per year (1 of every 5). People who quit smoking greatly reduce their risk for tobacco-related diseases, including cancer, heart disease, and lung disease, while also increasing life expectancy and improving quality of life. Each year, the economic costs due to tobacco use, including direct medical care and lost productivity, exceed $289 billion. For each pack of cigarettes sold, the societal costs due to smoking-related health care costs and lost productivity are estimated at $19.16 per pack, nearly 3 times the average cost of a pack of cigarettes ($6.16).

The good news is that 68% of all adults who smoke want to quit.5 Effective treatments are available—medications, behavioral counseling, or both—with successful quit rates of around 20-37% at least 6 months after quitting. However, most patients attempt to quit unassisted (without using proven cessation treatments). During 2015 only about one third of smokers used behavioral counseling and/or medications to assist them when trying to quit.

Over the past several years, research has guided our clinical approach to treating tobacco use and dependence. When used correctly, the FDA-approved medications for smoking cessation approximately double the likelihood of quitting. Further benefit is seen when medications are combined with behavioral counseling. Although more intensive interventions provide higher quit rates, even brief advice from healthcare providers—as few as 3 minutes—has been shown to have an impact on patients’ likelihood of quitting...


Publication Date: 11/22/2017
Expiration Date: 11/22/2020
CE Credit: 2.0 (0.20 CEU)
Type of Activity: Knowledge-based

This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.

Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.


Robin L. Corelli, PharmD, Professor of Clinical Pharmacy, Department of Clinical Pharmacy, at the University of California, San Francisco, School of Pharmacy.

Kroon, PharmD, Chair of the Department of Clinical Pharmacy and Professor of Clinical Pharmacy at the University of California, San Francisco, School of Pharmacy; Co-Director of the Fontana Tobacco Treatment Center at UCSF Health.

Karen S. Hudmon, DrPH, MS, RPh, Professor of Pharmacy Practice at Purdue University, West Lafayette, Indiana and Professor of Clinical Pharmacy at the University of California, San Francisco. All authors helped develop "Rx for Change," a nationally recognized clinician-assisted tobacco cessation training program.

Disclosure Statement

Disclosure: Dr. Corelli, Dr. Kroon, and Dr. Hudmon report no financial relationship with the manufacturer(s) or provider(s) of any 1 commercial product(s) or service(s) that appear in this issue.

Target Audience

This accredited program is targeted to pharmacists .

Goals & Objectives

At the conclusion of this program, participants will be able to:

    1. Discuss tobacco dependence and the symptoms of withdrawal from nicotine.
    2. List the 5 key components of comprehensive smoking cessation counseling. Apply the abbreviated “Ask-Advise-Refer” counseling approach. Be familiar with smoking cessation resources for patient referral.
    3. Assist patients with smoking cessation product selection and dosing based on tobacco use history. Discuss the advantages and disadvantages of each product. Describe the types of patients who might benefit from combination therapy.
    4. Discuss the contraindications and potential adverse effects of the FDA-approved medications for smoking cessation.

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The Rx Consultant is a publication of Continuing Education Network, Inc.

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Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education as a provider of continuing pharmacy education.

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Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.

ACPE Universal Activity Number: 0428-0000-17-011-H01-P

Exam & Credit Statement Procedures

Upon successful completion of this program and the post test (70%), 2.0 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Editorial and Review Board

Chief Editor and CE Administrator

Terry M. Baker, PharmD

Managing Editor

Tracy Farnen, PharmD

Associate Editors

James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Kaiser Permanente
Oakland, CA

Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA

Richard Ron Finley, B.S. Pharm.,R.Ph.
Clinical Pharmacist (volunteer faculty)
University of California, San Francisco (UCSF) Memory and Aging Center
Lecturer (Emeritus) UCSF, Department of Clinical Pharmacy
Health Sciences Clinical Professor, UCSF School of Pharmacy
San Francisco, CA

Consultant Pharmacist
Ray Dolby Brain Health Center, Sutter Health/CPMC
San Francisco, CA

Consult Pharmacist Aging and Adult Health Services
San Francisco Health Department
San Francisco, CA

Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System

Adjunct Clinical Professor
College of Pharmacy
Touro University
Vallejo, CA

Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Stockton, CA

Visiting Associate Professor and Lecturer
Nursing School
Samuel Merritt University
Oakland, CA

Pamela Mausner, MD

Helen Berlie, Pharm.D. CDE, BCACP
Clinical Assistant Professor, Pharmacy Practice
Wayne State University
Detroit, MI

Ambulatory Care Specialist - Diabetes
Health Centers Detroit Medical Group
Detroit, MI

Senior Editorial Advisor

Gerard Hatheway, PharmD, PhD

Editorial Advisors

Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Angie S. Graham, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD

Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners

Emily K.
Meuleman, RN, C, MS

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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