Medications


Medications plus counseling support can double the chances of quitting. There are 7 FDA-approved medications to help smoker's withdrawal symptoms when they cannot smoke or are trying to quit. Scroll down for detailed prescription tips, nicotine withdrawal symptoms, nicotine levels in medication vs. cigarettes, e-cigarette public health report, and medication interactions with smoke.  


Pharm Guide

Rx for Change Pharmacologic Product Guide:

Welcome to Rx for Change!

Rx for Change: Clinician-Assisted Tobacco Cessation is a comprehensive tobacco cessation training program that equips health professional students and practicing clinicians, of all disciplines, with evidence-based knowledge and skills for assisting patients with quitting. Our program draws heavily from the U.S. Public Health Service Clinical Practice Guideline for Treating Tobacco Use and Dependence, in that it advocates delivery of tailored behavioral counseling interventions in conjunction with pharmacotherapy. We address all forms of tobacco, not just cigarettes, and our materials focus on counseling all patients—regardless of their readiness to quit. All materials have undergone extensive external review by key experts in the field. 





 


Plasma Nicotine Concentrations: Tobacco Products vs. NRT

This graph depicts the plasma venous nicotine concentrations achieved with the various nicotine delivery systems. Peak plasma concentrations are higher and are achieved more rapidly when nicotine is delivered via cigarette smoke compared to the available NRT formulations.


What does this mean for your smoker?

 The green line above depicts the instant nicotine delivery via a cigarette versus NRT. As you can see, cigarettes deliver the nicotine rush much faster than NRT, so as providers, be aware of how much and how quickly you are providing your patient with NRT to treat nicotine withdrawal. 


Among the NRT options, the nasal spray has the most rapid absorption, followed by the gum, lozenge, and inhaler; absorption is slowest with the patch.

 


California Health Officer E-cigarette Report, 2015


E-cigarettes are not an FDA approved medication to aid in smoking cessation. 

For the 2015 California Health Officer Report, 

For the FDA website, click here.

http://stillblowingsmoke.org/










For the June 2016 Article on  E-Cigarettes and Smoking Cessation

Case Vignette
A Man Considering the Use of E-Cigarettes
James S. Yeh, M.D.,M.P.H.

Mr. O'Malley is a 29-year-old man whom you are seeing for the first time for a routine health check-up. He has a medical history of Obestiy, hypertension, and childhood seizures. During the visit he mentions that he is interested in quitting smoking. He started smoking cigarettes when he was 15 years old, while "hanging out" with his friends, and in those days smoked about half a pack a month. Read more here. http://www.nejm.org/doi/pdf/10.1056/NEJMclde1602420

 

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https://sites.google.com/a/ucquits.com/uc-quits/medications/e-cig.png?attredirects=0




The Lancet Respiratory Medicine

Smokers increasingly use e-cigarettes for many reasons, including attempts to quit combustible cigarettes and to use nicotine where smoking is prohibited. We aimed to assess the association between e-cigarette use and cigarette smoking cessation among adult cigarette smokers, irrespective of their motivation for using e-cigarettes.

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https://sites.google.com/a/ucquits.com/uc-quits/training/NEJM%20Marijuana.png



The New England Journal of Medicine

Here we review the current state of the science related to the adverse health effects of the recreational use of marijuanaAdverse Health Effects of Marijuana Use.


















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https://smokingcessationleadership.ucsf.edu/sites/smokingcessationleadership.ucsf.edu/files/Documents/FactSheets/Drug%20Interactions%20with%20Tobacco%20Smoke.pdf

As a provider, it is important to know that when your patients are using tobacco, it can interfere with their medications. 


This includes psychiatric medications and more.













*Content posted with permission from Rx for Change program