Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Persons: US Preventive Services Task Force Recommendation Statement.
Level 5 - mechanism / opinion, no new human data
Clinical practice guideline and expert recommendation statement
PubMed 33464343 · doi:10.1001/jama.2020.25019
What was done
The US Preventive Services Task Force (USPSTF) updated its 2015 recommendation statement by commissioning a systematic review evaluating the benefits and harms of primary care tobacco cessation interventions. The target population was adults aged 18 years or older, including pregnant persons. Interventions evaluated included behavioral interventions, FDA-approved pharmacotherapy, and electronic cigarettes.
What was found
The abstract reports context statistics (in 2019, 50.6 million US adults or 20.8% used tobacco; in 2016, 7.2% of pregnant women reported smoking), but reports no numeric effect estimates, odds ratios, or trial counts. Findings include: - High certainty of substantial net benefit for behavioral interventions and FDA-approved pharmacotherapy (alone or combined) for tobacco cessation in nonpregnant adults (Grade A recommendation). - High certainty of substantial net benefit for behavioral interventions on perinatal outcomes and smoking cessation in pregnant persons (Grade A recommendation). - Insufficient evidence to determine the balance of benefits and harms of pharmacotherapy interventions for smoking cessation in pregnant persons (I statement). - Insufficient evidence to determine the balance of benefits and harms of e-cigarettes for cessation in adults and pregnant persons due to a lack of well-designed randomized clinical trials reporting abstinence or adverse events (I statement).
Why it matters
This guideline provides high-level clinical guidance confirming first-line cessation strategies for adults and pregnant persons while identifying clear evidence gaps for e-cigarettes and pregnancy pharmacotherapy.
Limits
The abstract reports no study counts, participant sample sizes, or quantitative effect sizes from the commissioned review. Clinical trials are noted as critically lacking for e-cigarettes and sparse for pharmacotherapy in pregnancy.
Cited by
- supports Cigarette smoking causes approximately 480,000 deaths per year in the United States.