Tobacco Dependence: A Comprehensive Guide to Prevention and Treatment

Description

This book is a guide to pharmacotherapy treatment of tobacco dependence. The 2020 American Thoracic Society clinical practice guidelines on treating tobacco dependence serves as the cornerstone for this work with its robust discussion of recommended treatment options and how to tailor treatment to specific patient populations. Tobacco dependence remains a major health concern for many adults and given the dramatic increase of youth electronic cigarette use, clinicians need a singular resource to treat these different populations. This book addresses that by following the three main points of how to best address the adverse impact of tobacco use on public health: 1) prevent initiation of tobacco use; 2) understand mechanisms of addiction; 3) effectively treat tobacco dependence. The book begins by describing the current patterns of product use, the adverse impact of tobacco on global health, and tobacco-related health disparities. Authors discuss both combustible and electronic tobacco products, as well as current research on the adverse impact of vaping and associated flavorings including menthol, role of the e-cigarette in cessation, and treatment of adolescent nicotine dependence. Chapters conclude with a discussion of specific tobacco control policies to improve overall public health.    This is an ideal guide for pulmonologists, pediatricians, primary care physicians and other specialty providers who see patients with nicotine dependence. This book is also of interest to public health professions to help inform public health campaigns and treatment offerings to reduce overall tobacco product use through prevention and treatment. Preface Contents Contributors Chapter 1: Current Patterns of Tobacco Use and Health Disparities Introduction Health Equity in the Context of Tobacco and Understanding Tobacco-Related Disparities Why Should We Recognize Tobacco-Related Disparities? Poorer Outcomes for Those Who Face Disparities Higher Cost for Those Who Face Disparities Higher Tobacco Use and Secondhand Smoke Exposure Among Those Impacted by Tobacco-Related Disparities Patterns of Tobacco Use in Various Populations Age Education Gender Race/Ethnicity Income/Poverty Other Tobacco Products (OTP) Secondhand Smoke Exposure Sexual Orientation and Gender Identity Substance Use and Mental Health Disorders Occupation and Veteran Status Disability Geography Incarcerated People Why Do Tobacco-Related Disparities Exist? Social Determinants of Health Targeted Marketing by the Tobacco Industry Lack of Comprehensive Policies Changing US Population What Can We Do to Eliminate Disparities and Achieve Health Equity? Increasing Diversity of the Healthcare Team Address Inequities in Research Solving Inequalities in Access, Quality of Care, and Socioeconomic Status Implementing Appropriate Tobacco Control Policies References Chapter 2: Adverse Effects of Tobacco Products (Cigarettes, E-Cigarettes, Hookah, Smokeless Tobacco) Use on Health Introduction: Impact on Health of All Tobacco Products Mechanism of Injury of Tobacco Products Pathophysiology Oxidative Stress Genetics and Epigenetics Endothelial Dysfunction Inflammation and Infection Hemodynamic Effects Thrombogenic Effects Hormonal Alterations Lipid Abnormalities Specific Pathophysiology Related to Modes of Delivery and Additive Toxins Cigarettes Hookah Vaping and Electronic Nicotine Delivery Systems (ENDS) Smokeless Tobacco Organ-Specific Morbidity and Mortality Attributed to Tobacco Product Use Pulmonary Manifestations Acute Respiratory Infection Chronic Obstructive Pulmonary Disease (COPD) Asthma Respiratory Bronchiolitis Associated Interstitial Lung Disease (RB-ILD) Desquamative Interstitial Pneumonia (DIP) Pulmonary Langerhans Cell Histiocytosis (PLCH) Cardiovascular Manifestations Subclinical Atherosclerosis Peripheral Arterial Disease Coronary Heart Disease Cerebrovascular Disease Aortic Aneurysm Atrial Fibrillation Oncological Manifestations Lung Head and Neck Gastrointestinal (Esophageal, Gastric, Colorectal, Hepatobiliary, Pancreas) Genitourinary Blood Reproductive Manifestations Female Reproductive Health Male Reproductive Health Pregnancy Complications Perinatal and Infant Morbidity and Mortality Endocrine Manifestations Neuropsychiatric Manifestations Miscellaneous Manifestations Health Benefits of Cessation Summary References Chapter 3: Neurobiology and Mechanisms of Nicotine Addiction Introduction Neurobiology of Nicotine Addiction Acetylcholine (ACh) Nicotine nAChR Subtypes and Their Role in Nicotine Dependence Nicotine Pharmacology Case Creator: Dr. Hyma Gogineni Low Dose Nicotine Neurocognitive Effects of Nicotine Nicotine Withdrawal Symptoms (NWS) Case Creator: Dr. David Sachs Nicotine Toxicity and Teratogenicity Cues Support Nicotine and Tobacco Use Pharmacogenomics Case Creator: Dr. Hyma Gogineni Mental Health Disorders Existing Pharmacotherapies and nAChR Targets Initial Screening and Management New Developments Summary References Chapter 4: Pharmacotherapy for the Treatment of Tobacco Dependence Introduction Controller Medications Varenicline Bupropion Nicotine Patch Reliever Medications Nicotine Gum and Lozenge Nicotine Inhaler Nicotine Nasal Spray Practical Considerations Maximizing Initial Effectiveness Combination Therapy Common Treatment Moderators Psychiatric Comorbidities Patients Not Ready to Quit Managing Side Effects Relapse Prevention Conclusion References Chapter 5: Non-Pharmacologic Approaches to Tobacco Cessation Behavioral and Non-Pharmacological Approaches to Tobacco Cessation Conceptual Models Delivery Modalities Implementation Challenges Special Topics Quitting Smokeless Tobacco Quitting Nicotine Replacement Therapy COVID-19 and Tobacco Cessation: Recent Evidence Transcranial Magnetic Stimulation (TMS) Special Populations Racial and Ethnic Minority Populations American Indian/Alaskan Native Populations Sexual Minorities Smoking and Pregnancy Shifting Patterns of Tobacco Use Young Adults Conclusion and Recommendations References Chapter 6: Tobacco Dependence and Marginalized Populations: Key Considerations for Health Care Providers Background: Tobacco, Marginalized Populations, and Health Inequities Approaches to Tobacco Control, Management, and Treatment Health Care Providers’ Role in Addressing Tobacco Health Disparities Conclusion References Chapter 7: Treating Nicotine Dependence in the Pediatric Setting: Adolescents and Caregivers Who Smoke Introduction The Pediatric Setting Offers a Unique Opportunity and Responsibility to Address Smoking Caregiver Smoking Caregivers Who Smoke: An Opportunity and a Responsibility Epidemiology of Caregiver Smoking North America Outside North America Caregiver Smoking Is Concerning for Dependents Secondhand and Thirdhand Smoke SHS and THS Are Associated with Adverse Health Consequences SHS Is Associated with Increased Risk of Subsequent Child Smoking Screening for and Addressing Caregiver Smoking Treatment of Caregiver Smoking Counseling Nicotine Replacement Therapy Bupropion Varenicline Pediatric Smoking and Vaping Epidemiology of Pediatric Smoking and Vaping The Health Effects of Adolescent Vaping Are Concerning Adolescents Should Be Screened for e-Cigarette Use Treatment of Adolescent Nicotine Use Disorder Summary References Chapter 8: Treatment of Tobacco Dependence in the Inpatient Setting Treatment of Tobacco Dependence in the Inpatient Setting Benefits of Inpatient Tobacco Treatment Programs Structure of Inpatient Tobacco Treatment Programs Identification of Patients Staff and Providers Billing and Funding Integration in the Electronic Health Record (EHR) Inpatient Counseling Strategies Bedside Counseling Post-Discharge Counseling Inpatient Pharmacotherapy Considerations Types of Medication Post-Discharge Medications Summary, Challenges, and Future Directions References Chapter 9: Integration of Tobacco Dependence Treatment in Lung Cancer Screening and Other Ambulatory Care Settings Introduction Cessation Related Risk Reduction in Lung Cancer Screening, Cancer Care, and Beyond Lung Cancer Screening Lung Cancer Cancer Treatment Non-Cancer Related Conditions Marginalized Populations and Tobacco Use Disorder Systemic and Structural Racism and Cessation Services Quality and Personalized Patient Engagement Quality Healthcare Underpinnings Healthcare Provider Positionality, Implicit Bias, and Stigma Patient- and Family-Centered Care and Communication Lung Cancer Screening: An Opportunity for Patient-Centered Tobacco Treatment Care Lung Cancer Screening Shared Decision-Making Visits in Lung Cancer Screening Tobacco Cessation in Lung Cancer Screening Tobacco Use Disorder as a Chronic and Relapsing Condition Requires Comprehensive Cessation Services Tobacco Treatment Recommendations More Quit Attempts But Dismal Dissemination and Uptake of Cessation Services Key Components of Integrated Tobacco Treatment in Clinical Care National Call for Integration of Tobacco Treatment in Clinical Care Collaborative and Comprehensive Patient-Centered Care Healthcare Workforce Bridging Health Equity and Gaps in Cessation Services Considerations for Pragmatic Integration of Tobacco Treatment in Clinical Care Emerging Implementation Research for Tobacco Cessation Services in Cancer and Lung Cancer Screening Proposed Models for Integration of Cessation Services in Lung Cancer Screening Critical Components of Tobacco Cessation Services on the Front Lines Leveraging the Electronic Health Record to Support Integration of End-to-End Cessation Services Leveraging Telehealth to Facilitate Integration of Equitable Access to Care Making the Economic Business Case for Integrating Tobacco Treatment into Clinical Care Conclusion References Chapter 10: Bringing Treatment to the Patients: Community-Based Tobacco-Dependence Treatment and Interventions Community Health and Population Health Social Networks Housing Units Faith-Based Organizations School-Based Communities Principles of Community Engagement References Chapter 11: E-Cigarette: Friend or Foe? Introduction E-Cigarette and Its Components Harmful Effects on the Body Marketing Addictive Potential Perception Gateway to Tobacco Use Gateway to Illicit Drug Use Failures in Tobacco Cessation Success in Tobacco Cessation Comparison to Nicotine-Replacement Therapies Pathway to Dual Use Public Health Community Recommendations Conclusion References Chapter 12: Role of Menthol and Other Flavors on Tobacco and Nicotine Product Use Sensory Effects and Biological Mechanisms Tobacco Industry Marketing and Target Markets Health Messaging African-Americans Women Youth Consumer Perceptions Disparities in Use of Menthol Tobacco Products Landscape for Menthol Tobacco and Nicotine Products in the USA Market Share for Menthol Cigarettes Flavored E-Cigarettes Current US Regulations on Flavors in Tobacco and Nicotine Products Initiation and Progression to Regular Use Dependence Cessation Other Tobacco and Nicotine Products Solutions to Combat Flavored Tobacco Use Policy Reducing Disparities and Promoting Health Equity Cessation Resources Concluding Thoughts References Chapter 13: Promoting Training and Education in Tobacco Dependence Treatment Introduction Delivery of Tobacco Curriculum in Various HCP Fields Medical Students Graduate Medical Education Trainees Nursing Trainees Pharmacy Trainees Learning Content for Core Competencies in Evidence-Based Treatment of Tobacco Dependence Learning Strategies in an Educational Program for Tobacco Dependence Treatment Cognitive (C) and Skill (S) Objectives by Competency Area Delivery Methods Didactic Sessions Simulation Sessions Bedside Teaching Multimedia Online Resources and Toolkits Summary References Chapter 14: Increasing Access to Treatment for Nicotine Dependence Introduction Barriers to Successful Provider-Led Treatment Expanding Access to Cessation Support Granting Prescribing Authority to Community Pharmacists Standardizing Quitline-Delivered Care Smartphone and App-Based Nicotine Dependence Interventions Targeted Interventions for High-Risk Populations Veterans Affairs and Department of Defense Individuals Experiencing Homelessness LGBTQ+ Communities Providing Culturally Focused Treatments Native Americans African Americans Hispanics/Latinx Insurance Coverage of Treatment for Nicotine Dependence Conclusion References Chapter 15: Tobacco Control Policies to Reduce Tobacco Use Introduction Federal Policy and Legislation Milestones Achieved The Tobacco Control Act Was Signed into Law in 2009 The “Deeming Rule” Was Finalized in 2016 Tobacco 21 Became a Nationwide Law in 2019 FDA’s Role to Reduce Death and Disease from Tobacco Use: Progress, Pitfalls, Loopholes, and Challenges Graphic Warning Labels Menthol Nicotine Standards in Combustible Cigarettes Synthetic Nicotine Issue Orders for the Marketing of New Products Beyond the FDA: Other Federal Actions to Decrease Death and Disease from Tobacco Use The Centers for Disease Control and Prevention (CDC) National Institutes of Health (NIH) Centers for Medicare and Medicaid Services (CMS) State Policy and Advocacy National and State Tobacco Control Program (NTCP) Advocacy and Tobacco Control Organizations Smoke-Free Policy Increase Tobacco Taxes and Equalize Taxes Across All Tobacco Products Access to Cessation Services Increase Funding for State Tobacco Control Programs Pass Laws to Prohibit Sale of Flavored Tobacco Products, Including Menthol Cigarettes Global Tobacco Control Summary References Index