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Tobacco use screening and cessation

What the major U.S. guidelines recommend, with a link to verify each at the source. A quick-reference summary for clinicians, not medical advice.

USPSTF · 2021 · Grade A

Ask all adults about tobacco use; advise quitting; offer behavioral interventions plus FDA-approved pharmacotherapy (NRT, bupropion SR, varenicline) for nonpregnant adults (Grade A). Pregnant persons: ask, advise, behavioral interventions (Grade A); evidence insufficient for pharmacotherapy in pregnancy and for e-cigarettes (Grade I).

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ATS · 2020

For pharmacologic treatment, varenicline preferred over nicotine patch and over bupropion (strong). Start varenicline even in those not ready to quit rather than waiting (strong). Varenicline plus nicotine patch over varenicline alone (conditional). Use extended duration over 12 weeks over standard 6 to 12 weeks (strong).

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