Guias fiore

Clinical Practice Guideline

Treating Tobacco Use and Dependence: 2008 Update
Guideline Panel
Michael C. Fiore, MD, MPH (Panel Chair) Carlos Roberto Jaén, MD, PhD, FAAFP (Panel Vice Chair) Timothy B. Baker, PhD (Senior Scientist) William C. Bailey, MD, FACP, FCCP Neal L. Benowitz, MD Susan J. Curry, PhD Sally Faith Dorfman, MD, MSHSA Erika S. Froelicher, PhD, RN, MA, MPH Michael G. Goldstein,MD Cheryl G. Healton, DrPH Patricia Nez Henderson, MD, MPH Richard B. Heyman, MD Howard K. Koh, MD, MPH, FACP Thomas E. Kottke, MD, MSPH Harry A. Lando, PhD Robert E. Mecklenburg, DDS, MPH Robin J. Mermelstein, PhD Patricia Dolan Mullen, DrPH C. Tracy Orleans, PhD Lawrence Robinson, MD, MPH Maxine L. Stitzer, PhD Anthony C. Tommasello, PhD, MS Louise Villejo, MPH, CHES Mary Ellen Wewers, PhD,MPH, RN

Guideline Liaisons
Ernestine W. Murray, RN, BSN, MAS, (Project Officer), Agency for Healthcare Research and Quality Glenn Bennett, MPH, CHES, National Heart, Lung, and Blood Institute Stephen Heishman, PhD, National Institute on Drug Abuse Corinne Husten, MD, MPH, Centers for Disease Control and Prevention Glen Morgan, PhD, National Cancer Institute Christine Williams, MEd, Agency forHealthcare Research and Quality

Guideline Staff
Bruce A. Christiansen, PhD (Project Director) Megan E. Piper, PhD (Project Scientist) Victor Hasselblad, PhD (Project Statistician) David Fraser, MS (Project Coordinator) Wendy Theobald, PhD (Editorial Associate) Michael Connell, BS (Database Manager) Cathlyn Leitzke, MSN, RN-C (Project Researcher)

U.S. Department of Health and Human ServicesPublic Health Service May 2008

Guideline Update Development and Use
The 2008 update to Treating Tobacco Use and Dependence, a Public Health Service-sponsored Clinical Practice Guideline, is the result of an extraordinary partnership among Federal Government and nonprofit organizations comprised of the Agency for Healthcare Research and Quality; Centers for Disease Control and Prevention;National Cancer Institute; National Heart, Lung, and Blood Institute; National Institute on Drug Abuse; Robert Wood Johnson Foundation; American Legacy Foundation; and University of Wisconsin School of Medicine and Public Health’s Center for Tobacco Research and Intervention. Each member of this consortium is dedicated to improving the Nation’s public health, and their participation in thiscollaboration clearly demonstrates a strong commitment to tobacco cessation. This Guideline is an updated version of the 2000 Treating Tobacco Use and Dependence Guideline. It is the product of a private-sector panel of experts (“the Panel”), consortium representatives, and staff. The update was written to include new, effective clinical treatments for tobacco dependence that have become available since the2000 Guideline was published. Treating Tobacco Use and Dependence: 2008 Update will make an important contribution to the quality of care in the United States and the health of the American people. The Panel employed an explicit, science-based methodology and expert clinical judgment to develop recommendations on the treatment of tobacco use and dependence. Extensive literature searches wereconducted, and critical reviews and syntheses were used to evaluate empirical evidence and significant outcomes. Peer reviews were undertaken and public comment invited to evaluate the validity, reliability, and utility of the Guideline for clinical practice. The Panel’s recommendations primarily are based on published, evidence-based research. When the evidence was incomplete or inconsistent in aparticular area, the recommendations reflect the professional judgment of Panel members. The recommendations herein may not be appropriate for use in all circumstances and are designed particularly for clinical settings. Decisions to adopt any particular recommendation must be made by clinicians in light of available resources and circumstances presented by individual patients and in light of new...