USPSTF updates guidelines on smoking cessation

In January, the U.S. Preventive Services Task Force (USPSTF) issued recommendations for reducing tobacco use in adults, including pregnant individuals.

They found strong evidence to support behavioral interventions and FDA-approved pharmacotherapy for cessation in nonpregnant adults, and behavioral interventions in pregnant adults. USPSTF could not find sufficient data to safely recommend approved smoking cessation pharmacotherapies in pregnant women who smoke.

“The USPSTF concludes that the evidence on pharmacotherapy interventions for tobacco smoking cessation in pregnant persons is insufficient because few studies are available, and the balance of benefits and harms cannot be determined,” said the updated recommendations, which also appeared in JAMA.

Cigarette smoking among adults is at an all-time low—14% of the adult population said they smoke in 2019. However, nearly 70% of adults who smoke say they want to quit, and more than 50% try each year. Tobacco use remains the leading preventable cause of death and disease in the United States.

The 2020 report from the Surgeon General—the first report on smoking cessation in 30 years—found that fewer than 1 in 10 adults successfully quit smoking. That report also highlighted the important role pharmacists play in cessation efforts.

In the updated recommendations, USPSTF said:

  • The USPSTF recommends that clinicians ask all adults about tobacco use, advise them to stop using tobacco, and provide behavioral interventions and FDA-approved pharmacotherapy for cessation to nonpregnant adults who use tobacco. (A recommendation)
  • The USPSTF recommends that clinicians ask all pregnant persons about tobacco use, advise them to stop using tobacco, and provide behavioral interventions for cessation to pregnant persons who use tobacco. (A recommendation) 

USPSTF could not support a formal recommendation for the use of e-cigarettes in helping adults and pregnant women quit smoking.

“The USPSTF concludes that the evidence on the use of e-cigarettes for tobacco smoking cessation in adults, including pregnant persons, is insufficient, and the balance of benefits and harms cannot be determined. The USPSTF has identified the lack of well-designed, randomized clinical trials on e-cigarettes that report smoking abstinence or adverse events as a critical gap in the evidence,” the task force states.