Treatment of Tobacco Use Disorder in Primary Care
Treatment of Tobacco Use Disorder in Primary Care is organized by Providers Clinical Support System (PCSS).
Expiration Date: Jan 12, 2026
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 healthcare 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 the 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.
Educational Objectives:
• Identify the available forms of clinical assessment, including the utility of the Time to First Cigarette measure (TTFC)
• Demonstrate knowledge of evidence-based pharmacotherapies for tobacco use disorder treatment, highlighting the safety and efficacy of each
• Describe nicotine replacement treatment dosing and how to enhance its effectiveness in patients
• Review the role of counseling in increasing the success of quit attempts and describe the Ask, Advise, and Refer model for Primary Care