Screening

UK guidance from the National Institute for Health and Care Excellence (NICE) advises that health professionals ask people at every opportunity if they smoke, and if they smoke, deliver very brief advice (VBA) and refer to their local smoking cessation service.[63]​ The US Preventive Services Task Force (USPSTF) recommends that clinicians ask all adults about tobacco use at each visit, advise them to stop using tobacco, provide behavioural interventions to all adults who use tobacco, and provide US Food and Drug Administration (FDA)-approved pharmacotherapy for cessation to non-pregnant adults who use tobacco.[71] The American Academy of Pediatrics (AAP) recommends that all teenagers be screened for tobacco and nicotine use in primary care, and that those who want to stop smoking are offered referral for a behavioural intervention, with consideration given to offering nicotine replacement therapy (NRT) for those with moderate or severe tobacco dependence.[60]​​

Smoking status should be readily visible to the physician or healthcare professional at the point of care.[73][74]

A prompt in the electronic health record to mention smoking cessation may be beneficial, in addition to decision support tools and links to resources. These tools may increase the rate of physician cessation interventions, the proportion of smokers receiving behavioural support, and stopping rates.[95]

Screening for smoking with CO monitoring is recommended routinely for all pregnant women at antenatal appointments in some locations, including the UK.[63]​​​

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