4004F Patient screened for tobacco use and received tobacco cessation intervention (counseling, pharmacotherapy, or both), if identified as a tobacco user (PV, CAD)

Name of the Procedure:

Tobacco Use Screening and Cessation Intervention (Counseling, Pharmacotherapy or Both)

Summary

This procedure involves asking patients about their tobacco use and, if they are identified as tobacco users, providing interventions, such as counseling and/or medication, to help them quit.

Purpose

The procedure aims to identify tobacco users and provide them with the necessary support to quit smoking, thus reducing the risk of tobacco-related diseases such as cardiovascular diseases and pulmonary diseases.

Indications

• Current tobacco use (smoking or smokeless tobacco)
• History of tobacco use
• Patients with cardiovascular disease (CVD) or peripheral vascular disease (PVD)
• Patients at risk for or diagnosed with coronary artery disease (CAD)

Preparation

• No specific preparation required from the patient.
• A brief survey or questions about tobacco use history.

Procedure Description

1. Screening: The healthcare provider asks the patient about their tobacco use, including the type and frequency.
2. Assessment: Determine the patient's readiness to quit.
3. Intervention:
   • Counseling: Provide behavioral counseling and support.
   • Pharmacotherapy: Prescription of medications like nicotine replacement therapy, bupropion, or varenicline, if appropriate.
4. Follow-Up: Schedule follow-up visits or phone calls to support quitting process.

Duration

Approximately 5-15 minutes per session.

Setting

Outpatient clinic, primary care office, or hospital setting.

Personnel

• Primary care physician
• Nurse practitioner
• Behavioral health specialists or counselors
• Pharmacist (for pharmacotherapy management)

Risks and Complications

• Minimal risks associated with counseling.
• Possible side effects of pharmacotherapy (e.g., nausea, insomnia, headache with nicotine replacement therapy).

Benefits

• Increased likelihood of quitting tobacco.
• Improved overall health and reduced risk of tobacco-related diseases.
• Benefits may be noticed within weeks to months, including improved breathing and cardiovascular health.

Recovery

• No recovery needed.
• Continuous support and follow-ups are essential to maintain tobacco cessation.

Alternatives

• Self-help materials and mobile apps for quitting tobacco.
• Support from family and friends.
• Hypnotherapy and acupuncture (alternative but less evidence-based methodologies).

Patient Experience

• Patients may experience challenges and cravings when quitting.
• Support and motivational interviewing can significantly enhance patient comfort and success.
• Counseling sessions provide emotional and psychological support.