Effective behavioral and pharmacological treatments for smoking cessation are underutilized across the population, but especially among the poor.
Based on a recent comprehensive review of the effectiveness of different smoking cessation treatments, the USPHS recommended that all smokers receive practical behavioral counseling and support to quit, preferably in combination with FDA approved smoking cessation medication. It also recommended that health care workers screen all patients for tobacco use and provide advice with follow-up behavioral treatments to all tobacco users. In addition, the USPHS recommends that smoking cessation medications be made available to all smokers who wish to quit.
Despite these treatment guidelines, population based surveys reveal that most tobacco users today are not receiving treatment assistance from their health care providers. For example, a recent survey reported that tobacco counseling occurred in less than one-fourth of doctor visits by tobacco users and cessation medications were prescribed on less than 3% of occasions.
Interestingly, the odds of getting a prescription for a stop smoking medication increased 15-fold if the patient requested it. Studies by SAPRP investigators have documented that the utilization of proven smoking treatments is lowest among those who are uninsured and those who have the greatest need for assistance in quitting tobacco (such as smokers with mental health and other substance abuse problems). Similar findings have been found by others.
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