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Ask (about tobacco use)

Advise (to quit)

Assess (stage of patient)

Assist (quitting)

Arange (follow up care)

1. not within the next month
2. ready to quit next month
3. quit within last 6 months
4. quit over 6 months ago

Used when patient is stage 1

• Relevance (why important to pt)
  
• Risks (PT identifies)
• Rewards (PT identifies)
• Roadblocks
• Repetition (repeat often)

• NRT
• Bupropion
• Vareniciline

>10 cigarettes/day

21mg patch X6W

14mg patch X2W

7mg patch X2W

<10 cigarettes/day

14mg patch X6W

7mg patch X2W

>25 cigarettes/day

4mg piece Q 1-2 H X weeks 1-6

4mg piece Q 2-4 H X weeks 7-9

4mg piece Q 4-8 H X weeks 10-12

<25 cigarettes/day

2mg piece Q 1-2 H X weeks 1-6

2mg piece Q 2-4 H X weeks 7-9

2mg piece Q 4-8 H X weeks 10-12

TTFC <30 minutes from wakeing

4mg piece Q 1-2H X weeks 1-6

4mg piece Q 2-4H X weeks 7-9

4mg piece Q 4-8H X weeks 10-12

TTFC >30 minutes from waking

2mg piece Q 1-2H X weeks 1-6

2mg piece Q 2-4H X weeks 7-9

4mg piece Q 4-8H X weeks 10-12

6-16 cartridges/day X 3-12 weeks

then taper over the next 6-12 weeks

1-2 sprays/hour

increase PRN to max of 5 sprays/hour

use at least 8 sprays/day for 6-8W

taper over 4-6W

150mg QD X3D then

150mg BID X7-12 weeks

if not successful by week 7, discontinue

start 1-2 weeks before quit date

partial nicotinic receptor agonist

0.5mg PO QD X3D

0.5mg PO BID X4D

1mg PO BID