JACC Focus Seminar: CV Health Promotion
JACC Focus Seminar
Prevention and Treatment of Tobacco Use: JACC Health Promotion Series

https://doi.org/10.1016/j.jacc.2018.06.036Get rights and content
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Abstract

Tobacco use is the leading preventable cause of death worldwide and is a major risk factor for cardiovascular disease (CVD). Both prevention of smoking initiation among youth and smoking cessation among established smokers are key for reducing smoking prevalence and the associated negative health consequences. Proven tobacco cessation treatment includes pharmacotherapy and behavioral support, which are most effective when provided together. First-line medications (varenicline, bupropion, and nicotine replacement) are effective and safe for patients with CVD. Clinicians who care for patients with CVD should give as high a priority to treating tobacco use as to managing other CVD risk factors. Broader tobacco control efforts to raise tobacco taxes, adopt smoke-free laws, conduct mass media campaigns, and restrict tobacco marketing enhance clinicians’ actions working with individual smokers.

Key Words

nicotine
smoking
smoking cessation
smoking prevention
tobacco use disorder

Abbreviations and Acronyms

CHD
coronary heart disease
CVD
cardiovascular disease
e-cigarette
electronic cigarette
FDA
U.S. Food and Drug Administration
MI
myocardial infarction
NRT
nicotine replacement therapy
TSE
tobacco smoke exposure

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Dr. Kalkhoran’s work in preparation of this paper was supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (K23HL136854). Dr. Rigotti’s work was also supported by the NHLBI (R01 HL11821). The funders had no role in the design and conduct of the study, in the collection, analysis, and interpretation of the data, or in the preparation, review, or approval of the manuscript. Drs. Kalkhoran, Rigotti, and Benowitz receive royalties from UpToDate for chapters on electronic cigarettes, smoking cessation, and the cardiovascular effects of nicotine. Dr. Benowitz has been a paid consultant to Pfizer, Inc., and Achieve Life Sciences; has served on the advisory board for Pfizer; and has been an expert witness in litigation against tobacco companies. Dr. Rigotti has received a research grant from and been an unpaid consultant to Pfizer; and has served as a paid consultant to Achieve Life Sciences.

Listen to this manuscript's audio summary by JACC Editor-in-Chief Dr. Valentin Fuster.