The new recommendations name varenicline and combination nicotine replacement therapy as preferred treatments for tobacco use cessation.
RT’s Three Key Takeaways:
- Preferred Pharmacotherapies: The guideline recommends varenicline or combination nicotine replacement therapy as the primary medical treatments to increase tobacco abstinence.
- Expanded Treatment Access: Clinicians are urged to offer interventions even to patients who are not yet ready to quit, as well as prompt retreatment for individuals who relapse.
- Mental Health Safety: The recommendations highlight the safety and efficacy of cessation medications for patients with mental health conditions, emphasizing counseling and motivational interviewing to support engagement.
The US Department of Veterans Affairs (VA) and Department of Defense (DoD) have released an updated clinical practice guideline recommending varenicline or combination nicotine replacement therapy as the preferred treatments for tobacco cessation, according to a synopsis published in Annals of Internal Medicine.
The updated guidance addresses nicotine and tobacco use among service members and veterans, noting that use leads to adverse physical and mental health effects, and reduces military force readiness. For respiratory therapists and allied healthcare professionals treating patients with chronic lung conditions and nicotine dependence, the document outlines practical strategies to improve long-term abstinence rates.
To develop the guideline, a multidisciplinary panel convened by the VA and DoD evaluated clinical research published between 2014 and 2024. The resulting guideline features 32 recommendations addressing cessation medications, counseling techniques, and management strategies for adults who use diverse tobacco and nicotine products.
Focus on Pharmacotherapy and Behavioral Support
In addition to recommending varenicline and combination nicotine replacement therapy to increase quit rates, the panel emphasized that pharmacotherapy is both safe and effective for patients who present with co-occurring mental health conditions.
The guideline also advises healthcare providers to maintain engagement across varying stages of patient readiness. Key recommendations include:
- Employing motivational interviewing strategies to boost patient engagement in cessation care.
- Offering cessation therapy to adults even if they report they are not yet ready to quit.
- Initiating immediate retreatment for patients who experience a relapse.
According to the guideline synopsis, the combination of evidence-based medications and counseling remains the most effective approach for achieving successful tobacco and nicotine cessation.
