单位：[1]Department of Pediatrics, Division of PulmonaryMedicine, Texas Children’s Hospital and BaylorCollege of Medicine, Houston, Texas[2]Comprehensive Smoking Treatment Program,Perelman School of Medicine, University ofPennsylvania, Philadelphia, Pennsylvania[3]Pharmaceutical Science Graduate Course,University of Sorocaba, Sorocaba, Sa˜ o Paulo,Brazil[4]Division of Pulmonary and Critical CareMedicine, Johns Hopkins University, Baltimore,Maryland[5]Department of Psychiatry,Massachusetts General Hospital, HarvardUniversity, Cambridge, Massachusetts[6]Department of Biobehavioral Nursing andHealth Informatics, School of Nursing, Universityof Washington, Seattle, Washington[7]PublicAdvisory Roundtable, American ThoracicSociety, New York, New York[8]Center forTobacco Control, Northwell Health, Great Neck,New York[9]College of Pharmacy, WesternUniversity of Health Sciences, Pomona,California[10]Veterans Affairs Loma LindaAmbulatory Care Center, Redlands, California[11]Department of Pulmonary Medicine, School ofMedicine, Louisiana State University, NewOrleans, Louisiana[12]Department of Pulmonaryand Critical Care Medicine, Boston UniversityMedical Center, Boston, Massachusetts[13]Pennsylvania Society for Respiratory Care,Philadelphia, Pennsylvania[14]Division ofEpidemiology and Public Health, University ofNottingham, Nottingham, United Kingdom[15]Library and Archives, American DentalAssociation, Chicago, Illinois[16]Department ofInternal Medicine and Pulmonology,Technological University of Pereira, Pereira,Colombia[17]Colombian Association ofPulmonology and Thoracic Surgery, Bogota´ ,Colombia[18]Colombian Association of InternalMedicine, Bogota´ , Colombia[19]Department ofPulmonology, Ottawa Hospital ResearchInstitute, Ottawa, Ontario, Canada[20]Michael G.DeGroote School of Medicine and 22Departmentof Health Research Methods, Evidence, andImpact, McMaster University, Hamilton, Ontario,Canada[21]Fire Department of New York, NewYork, New York[23]Palo Alto Center forPulmonary Disease Prevention, Palo Alto,California[24]Hollings Cancer Center, MedicalUniversity of South Carolina, Charleston, SouthCarolina[25]Department of Pulmonary Medicine,New Mexico Veterans Affairs Health CareSystem, Albuquerque, New Mexico[26]Tobacco Medicine and Tobacco CessationCenter, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
Background: Current tobacco treatment guidelines have established the efficacy of available interventions, but they do not provide detailed guidance for common implementation questions frequently faced in the clinic. An evidence-based guideline was created that addresses several pharmacotherapy-initiation questions that routinely confront treatment teams. Methods: Individuals with diverse expertise related to smoking cessation were empaneled to prioritize questions and outcomes important to clinicians. An evidence-synthesis team conducted systematic reviews, which informed recommendations to answer the questions. The GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach was used to rate the certainty in the estimated effects and the strength of recommendations. Results: The guideline panel formulated five strong recommendations and two conditional recommendations regarding pharmacotherapy choices. Strong recommendations include using varenicline rather than a nicotine patch, using varenicline rather than bupropion, using varenicline rather than a nicotine patch in adults with a comorbid psychiatric condition, initiating varenicline in adults even if they are unready to quit, and using controller therapy for an extended treatment duration greater than 12 weeks. Conditional recommendations include combining a nicotine patch with varenicline rather than using varenicline alone and using varenicline rather than electronic cigarettes. Conclusions: Seven recommendations are provided, which represent simple practice changes that are likely to increase the effectiveness of tobacco-dependence pharmacotherapy.
基金：
NCATS NIH HHSUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Center for Advancing Translational Sciences (NCATS) [UL1 TR001863] Funding Source: Medline
第一作者单位：[1]Department of Pediatrics, Division of PulmonaryMedicine, Texas Children’s Hospital and BaylorCollege of Medicine, Houston, Texas
共同第一作者：
通讯作者：
通讯机构：[2]Comprehensive Smoking Treatment Program,Perelman School of Medicine, University ofPennsylvania, Philadelphia, Pennsylvania[*1]Comprehensive Smoking Treatment Program, Penn Lung Center, Suite 251, Wright-Saunders Building, 51 North 39th Street, Philadelphia, PA 19104
推荐引用方式(GB/T 7714)：
HAROLD J,FRANK T. LEONE,LUCIANE CRUZ-LOPES,et al.Initiating Pharmacologic Treatment in Tobacco-Dependent Adults An Official American Thoracic Society Clinical Practice Guideline[J].AMERICAN JOURNAL of RESPIRATORY and CRITICAL CARE MEDICINE.2020,202(2):E5-E31.doi:10.1164/rccm.202005-1982ST.
APA：
HAROLD J,FRANK T. LEONE,LUCIANE CRUZ-LOPES,MICHELLE N. EAKIN,A. EDEN EVINS...&MENG ZHU.(2020).Initiating Pharmacologic Treatment in Tobacco-Dependent Adults An Official American Thoracic Society Clinical Practice Guideline.AMERICAN JOURNAL of RESPIRATORY and CRITICAL CARE MEDICINE,202,(2)
MLA：
HAROLD J,et al."Initiating Pharmacologic Treatment in Tobacco-Dependent Adults An Official American Thoracic Society Clinical Practice Guideline".AMERICAN JOURNAL of RESPIRATORY and CRITICAL CARE MEDICINE 202..2(2020):E5-E31
医学