Medication Considerations

1) Identify smoking triggers + coping strategies 

     -- smoking APP

2) Set quit date within 30 days

3) Replacement therapy

     -- Nicotine patch: long-acting, steady state levels

     -- Gum/ lozenges: short-acting for craving relief

4) Medication therapy (start before quit date)

     -- bupropion 

     -- Varenicline (Chantix)

REPLACEMENT THERAPY

The patient is a light smoker (less than 1/2 PPD)

Transdermal patch (7 mg/ 24 hr.)

REPLACEMENT THERAPY

The patient is a moderate smoker (1/2 PPD to 1 PPD)

Transdermal patch (14 mg/ 24 hr.)

REPLACEMENT THERAPY

The patient is a heavy smoker (> 1 PPD)

Transdermal patch (21 mg/ 24 hr.)

Medication Management

Bupropion SR 150  
150 mg/d for 3 days, then 150 mg BID
Start 1 wk before quit date
Continue for 3-6 months
Lowers seizure threshold do not use of history of seizures)

Varenicline
0.5 mg/d for 3 days, then 0.5 mg BID for 4 days, then 1 mg BID
Start 1 wk before quit date
Continue for 3-6 months

Thank the patient for their time.  Hit the submission button below.  

We don't bill for our time.

Thank the patient for their time.  You will send patient resources on how to quit smoking.  For now you share the following educational points on why they should quit smoking:

1) Cigarette smoking is the leading cause of preventable death in the United States.

2) Smokers are more likely than nonsmokers to develop heart disease, stroke, and lung cancer.

3) Smoking can cause cancer almost anywhere in your body 

Thank the patient for their time. You will send patient resources on how to quit vaping. For now you share the following educational points on vaping nicotine:

1) Vaping is less harmful than smoking, but it’s still not safe.  The long-term effects of e-cigarettes are still unknown, and all tobacco products, including e-cigarettes, can pose health risks to the user.

2) Research suggests vaping is bad for your heart and lungs.

3) Electronic cigarettes are just as addictive as traditional ones.

4) Electronic cigarettes aren’t the best smoking cessation tool.

Thank the patient for their time. You will send patient resources on how to quit chewing tobacco. For now you share the following educational points on chewing tobacco:

1) Chewing tobacco can cause many types of cancer, including cancer of the mouth, tongue, gums, stomach, oesophagus (throat) and bladder.

2) Regular chewing tobacco use is linked to higher heart attack risks too, since it is known to raise blood pressure and cholesterol levels.

3) Chewing tobacco contains more nicotine than cigarettes and can be even more difficult to quit than smoking. Having a regular amount of chew in your mouth for 30 minutes will give you as much nicotine as three cigarettes.