Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC.
Department of Psychiatry, Washington University in St. Louis, St. Louis, MO.
Chest. 2021 Apr;159(4):1652-1663. doi: 10.1016/j.chest.2020.11.025. Epub 2020 Nov 28.
Because tobacco use remains one of the leading causes of disease, disability, and mortality, tobacco treatment programs should be integrated into medical systems such as hospitals and outpatient centers. Medical providers have a unique, high-impact opportunity to initiate smoking cessation treatment with patients. However, there are several barriers that may hinder the development and implementation of these programs. The purpose of this review was to address such barriers by illustrating several examples of successful tobacco treatment programs in US health-care systems that were contributed by the authors. This includes describing treatment models, billing procedures, and implementation considerations. Using an illustrative review of vignettes from existing programs, various models are outlined, emphasizing commonalities and unique features, strengths and limitations, resources necessary, and other relevant considerations. In addition, clinical research and dissemination trials from each program are described to provide evidence of feasibility and efficacy from these programs. This overview of example treatment models designed for hospitals and outpatient centers provides guidelines for any emerging tobacco cessation services within these contexts. For existing treatment programs, this review provides additional insight and ideas about improving these programs within their respective medical systems.
由于吸烟仍然是导致疾病、残疾和死亡的主要原因之一,因此应将烟草治疗方案纳入医院和门诊中心等医疗系统中。医疗服务提供者有一个独特的、具有重大影响的机会,可以为患者启动戒烟治疗。然而,有几个障碍可能会阻碍这些项目的开发和实施。本综述的目的是通过举例说明美国医疗保健系统中几位作者提供的成功的烟草治疗方案来解决这些障碍。这包括描述治疗模式、计费程序和实施注意事项。通过对现有方案的案例描述进行说明性回顾,概述了各种模式,强调了共性和独特性、优势和局限性、所需资源以及其他相关注意事项。此外,还描述了每个方案的临床研究和传播试验,以提供这些方案可行性和疗效的证据。为医院和门诊中心设计的这些治疗模式示例的概述为这些环境中任何新出现的烟草戒烟服务提供了指导方针。对于现有的治疗方案,本综述为改善各自医疗系统中的这些方案提供了更多的见解和思路。