USPSTF Reaffirms Recommendations on Tobacco Cessation Counseling

Clinicians should ask all adults about use of tobacco products and provide cessation interventions to current users, the U.S. Preventive Services Task Force says in a reaffirmation of its 2003 recommendation statement.

The guideline, appearing in Annals of Internal Medicine, specifies a "5-A" approach to counseling:

* Ask about tobacco use.
* Advise to quit through personalized messages.
* Assess willingness to quit.
* Assist with quitting.
* Arrange follow-up care and support.

The USPSTF says brief behavioral counseling (under 10 minutes) and pharmacotherapy are each effective alone — although they're most effective when used together.

The task force also advises clinicians to ask all pregnant women, regardless of age, about tobacco use. Those who currently smoke should receive pregnancy-tailored counseling supplemented with self-help materials. (Evidence on pharmacotherapy use in pregnancy was deemed "inadequate.")