HWN Suggests

Tobacco Use Disorder

Tobacco use disorder remains responsible for the majority of preventable deaths in the Western world. Worldwide, nearly 1.4 billion people regularly use tobacco. In 2019, the World Health Organization announced its first-ever projected reduction in the number of men who use tobacco, with a total anticipated reduction of nearly 60 million individuals who use tobacco. Of course, the prevalence of tobacco use disorder varies significantly across demographic, economic, and cultural groups, but the highest burden is borne by people from lower socioeconomic individuals, as well as people with mental health and substance use disorders.

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 Tobacco Use

Pharmacotherapy and behavioral support are each effective when used alone, but combining them is more effective. Combined pharmacotherapy and behavioral interventions increased quit rates from a mean of 8.6% with brief advice or usual care to 15.2% in a pooled analysis. • Pharmacotherapy helps reduce nicotine withdrawal symptoms (i.e., nicotine replacement therapy [NRT]) and/or minimizes the favorable effects experienced while smoking (i.e., varenicline), while behavioral interventions seek to change learned behaviors associated with smoking.

Articles of Interest

Clinical Interventions to Treat Tobacco Use and Dependence Among Adults

Tobacco use and dependence is a chronic, relapsing condition that often requires repeated intervention and long-term support. Quitting can be hard, but evidence-based treatments improve success.

Integrating Tobacco Use Disorder Interventions in Addiction Treatment

Common misconceptions have limited the use of tobacco use disorder interventions in addiction treatment settings. Many clinicians mistakenly believe that encouraging patients to address their tobacco use disorder may disrupt the treatment for other SUDs. However, research has clearly demonstrated the efficacy of treating tobacco use disorder in parallel with other SUDs.

Nicotine Dependence

Tobacco use disorder is the most common substance use disorder in the United States. Approximately 60% to 80% of current smokers fulfill classic criteria for drug dependence; e.g., they have difficulty stopping, have withdrawal when they stop, are tolerant and continue despite knowledge of personal harm. Nicotine is the primary addictive substance in tobacco; however other chemicals likely increase the addiction risk.

Nicotine replacement therapy versus control for smoking cessation

All of the commercially available forms of nicotine replacement therapy (NRT), i.e. gum, transdermal patch, nasal spray, inhalator, oral spray, lozenge and sublingual tablet, are effective as part of a strategy to promote smoking cessation. They increase the rate of long‐term quitting by approximately 50% to 60%, regardless of setting. These conclusions apply to smokers who are motivated to quit. There is little evidence about the role of NRT for individuals smoking fewer than 10 to 15 cigarettes a day.

Tobacco-Related Disorders

Tobacco-related disorders include tobacco use disorder and tobacco withdrawal. Tobacco and tobacco-based products contain many harmful substances, including nicotine, a highly addictive chemical that causes changes in the brain that result in cravings for more nicotine. Those with tobacco-use disorder continue to use tobacco, whether through smoking or chewing/dipping, even though they know it is harmful. Tobacco use disorder is the most common substance use disorder in the U.S., as well as a major cause of disability and early death. Exposure to tobacco smoke can also cause early death in nonsmokers.

Why CVS Quit Smoking

What inspired CVS’s rhetorical shift from saving pennies to saving lives? Again, as in the sixties, a change in the law has presented businesses with an opportunity.

Resources

Truth

We're not here to criticize your choices, or tell you not to smoke. We're here to arm everyone – smokers and non-smokers – with the tools to make change.

UNDO

As a California Department of Public Health program, we want to undo the damage – poison, pollution, and prejudice – done by the tobacco industry. Californians deserve clean air and water, healthy kids, and vibrant diverse communities. How to get there? By holding the tobacco industry to the same standards as everyone else.

CDC

Tobacco use and dependence is a chronic, relapsing condition that often requires repeated intervention and long-term support. Quitting can be hard, but evidence-based treatments improve success.

NCD Alliance

Of the 1.13 billion smokers around the world, half of them will die from a tobacco-related disease, which in the vast majority of cases will be a noncommunicable disease (NCD) like lung and heart disease or cancer.